Chonnam Med J.  2009 Aug;45(2):98-104. 10.4068/cmj.2009.45.2.98.

Clinical Spectrum and Risk Factors for Erosive and Non-erosive Gastroesophageal Reflux Disease

• Song YA
• Jin NC
• Ryoo KH
• Cho DK
• Park SY
• Yoon KW
• Kim HS
• Choi SK
• Rew JS

• KMID: 2172268
• DOI: http://doi.org/10.4068/cmj.2009.45.2.98

Abstract

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea. Obesity, old age, hiatal hernia, and a high-calorie diet are generally known as risk factors for GERD. But not enough research has been done on the many factors affecting the diagnostic severity of endoscopic esophagitis. The purpose of this study was to evaluate the relationship between endoscopic findings and variable clinical factors in patients with GERD. A retrospective study was performed in 258 patients with heartburn or acid reflux symptoms who underwent endoscopy from January 2005 to April 2008 at Chonnam National University Hospital. Patients were classified in the ERD (erosive reflux disease) or NERD (non-erosive reflux disease) group depending on the presence of erosion. The risk of endoscopic esophagitis was analyzed with regard to several variables, such as symptom severity, age, BMI, presence of endoscopically suspected esophageal metaplasia (ESEM), smoking, alcohol, caffeine, exercise, Helicobacter pylori, lipid profiles, and use of hypnotics. The incidence of endoscopically suspected NERD was 59.3% (153 patients) and that of ERD was 40.7% (105 patients). Hiatal hernia was more frequent in the ERD group [30.1% (31/103)] than in the NERD group [15.7% (24/153); p=0.006]. Endoscopically suspected Barrett's esophagus was more frequent in the NERD group [23.5% (36/153)] than in the ERD group [13.6% (14/103); p=0.049]. Use of hypnotics was more frequent in the ERD group [14.9% (14/94)] than in the NERD group [8.7% (13/149); p=0.136]. By logistic regression analysis, erosive esophagitis was correlated with hiatal hernia [adjusted odds ratio (aOR)=2.70, 95% confidence interval (CI): 1.39~5.25, p=0.004] and use of hypnotics (aOR=2.50, 95% CI: 1.07~5.84, p=0.035). In GERD, risk factors for esophageal mucosal damage were hiatal hernia and sleep disturbance.

Keyword

Gastroesophageal reflux; Risk factors

MeSH Terms

Barrett Esophagus
Caffeine
Diet
Endoscopy
Esophagitis
Gastroesophageal Reflux
Heartburn
Helicobacter pylori
Hernia, Hiatal
Humans
Hypnotics and Sedatives
Incidence
Korea
Logistic Models
Metaplasia
Obesity
Odds Ratio
Prevalence
Retrospective Studies
Risk Factors
Smoke
Smoking
Caffeine
Hypnotics and Sedatives
Smoke

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