Or is it just a little relaxation?

Or is it just a little relaxation?

Lagergren et al. performed a population-based, case-control study to investigate the possible association between use of lower esophageal sphincter (LES)–relaxing medications and risk for adenocarcinoma of the esophagus, squamous cell cancer of the esophagus, and adenocarcinoma of the gastric cardia. They used randomly selected population-based controls from their population registry. The authors identified five groups of medications introduced before 1970 as LES relaxing: nitroglycerin, anticholinergics, β-adrenergic agonists, aminophylline, and benzodiazepines. They demonstrated an association, which they felt was causal, between the use of LES-relaxing medications and risk for adenocarcinoma of the esophagus. Long term use of LES-relaxing drugs correlated positively with the degree of esophageal adenocarcinoma risk, as demonstrated by an incidence rate ratio of 3.8 for esophageal adenocarcinoma in patients who used LES-relaxing drugs, particularly anticholinergics, daily for >5 yr. Importantly, they also found a higher prevalence of reflux among users of LES-relaxing agents. Cardia adenocarcinoma and esophageal squamous cell carcinoma were in general not associated with the use of these drugs, though a weaker association was noted with long term use of nitroglycerin and adenocarcinoma of the gastric cardia. No consistent association between use of LES-relaxing drugs and risk for esophageal squamous cell carcinoma was found.