Objective: This study aims to determine the correlation between risk factors and erosive esophagitis development.
Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.
Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).
Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Diaz-Rubio M, Moreno-Elola-Olaso C, Rey E, Locke GR, Rodriguez-Artalejo F – Symptoms of gastro-oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther. 2004;19:95–105.
2. Mohammed I, Cherkas LF, Riley SA, Spector TD, Trudgill NJ – Genetic influences in gastro-oesophageal reflux disease: a twin study. Gut. 2003;52:1085–1089.
3. Terry P, Lagergren J, Wolk A, Nyrén O – Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric cardia. Nutr Cancer. 2000;38:186–191.
4. El-Serag HB, Petersen NJ, Carter J et al – Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;126:1692–1699.
5. Kim N, Lee SW, Cho SI et al – The prevalence of and risk factors for erosive oesophagitis and non-erosive reflux disease: a nationwide multicenter prospective study in Korea. Aliment Pharmacol Ther. 2008;27(2):173-185.
6. Okamoto K, Iwakiri R, Mori M et al – Clinical symptoms in endoscopic reflux esophagitis: Evaluation in 8031 adult subjects. Dig Dis Sci. 2003;48:2237–2241.
7. Rosaida MS, Goh KL – Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol. 2004;16:495–501.
8. Royston C, Bardhan KD –Adam, Eve and the reflux enigma: age and sex differences across the gastro-oesophageal reflux spectrum. Eur J Gastroenterol Hepatol. 2017;29(6):634-639
9. Conrado LM, Gurski, da Rosa AR– Is there an association between hiatal hernia and ineffective esophageal motility in patients with gastroesophageal reflux disease? J Gastrointest Surg. 2011;15(10):1756-1761.
10. Rubenstein JH, Inadomi JM, Scheiman J et al – Association between Helicobacter pylori and Barrett’s esophagus, erosive esophagitis, and gastroesophageal reflux symptoms, Clin Gastroenterol Hepatol. 2014;12(2):239-245.
11. Vaira D, Vakil N, Rugge M et al – Effect of Helicobacter pylori eradication on development of dyspeptic and reflux disease in healthy asymptomatic subjects. Gut. 2003;52:1543–1547.
12. Kim N, Lee SW, Kim JI et al – Effect of Helicobacter pylori eradication on the development of reflux esophagitis and gastroesophageal reflux symptoms: a nationwide multi-center prospective study. Gut Liver. 2011;5:437–446.
13. Lee YC, Chen TH, Chiu HM et al – The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention. Gut. 2013;62:676–682.
14. Xinias I, Maris T, Mavroudi A, Panteliadis C, Vandenplas Y – Helicobacter pylori infection has no impact on manometric and pH-metric findings in adolescents and young adults with gastroesophageal reflux and antral gastritis: eradication results to no significant clinical improvement. Pediatr Rep. 2013;5:e3.
15. Guntipalli P, Chason R, Elliott A et al – Upper gastrointestinal bleeding caused by severe esophagitis: a unique clinical syndrome. Dig Dis Sci. 2014;59(12):2997-3003.