# Gastroesophageal Disease and Environmental Exposure: A Systematic Review

## TL;DR

This review explores how environmental exposures like air pollution and smoking are linked to upper gastrointestinal diseases.

## Contribution

The study highlights waterpipe use as a new risk factor for gastroesophageal reflux and gastric cancer.

## Key findings

- PM exposure increases the risk of upper gastrointestinal diseases.
- Smoking is confirmed as a major risk factor for aerodigestive diseases.
- Waterpipe use is significantly associated with gastroesophageal reflux and gastric cancer.

## Abstract

Environmental exposure-associated disease is an active area of study, especially in the context of increasing global air pollution and use of inhalants. Our group is dedicated to the study of exposure-related inflammation and downstream health effects. While many studies have focused on the impact of inhalants on respiratory sequelae, there is growing evidence of the involvement of other systems including autoimmune, endocrine, and gastrointestinal.

This systematic review aims to provide a recent update that will underscore the associations between inhalation exposures and upper gastrointestinal disease in the contexts of our evolving environmental exposures. Keywords focused on inhalational exposures and gastrointestinal disease. Primary search identified n = 764 studies, of which n = 64 met eligibility criteria. In particular, there was support for existing evidence that PM increases the risk of upper gastrointestinal diseases. Smoking was also confirmed to be major risk factor. Interestingly, studies in this review have also identified waterpipe use as a significant risk factor for gastroesophageal reflux and gastric cancer.

Our systematic review identified inhalational exposures as risk factors for aerodigestive disease, further supporting the association between environmental exposure and digestive disease. However, due to limitations on our review’s scope, further studies must be done to better understand this interaction.