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The Clinical Features and Predisposing Factors of Asymptomatic Erosive Esophagitis

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Abstract

Background

Asymptomatic erosive esophagitis (AEE) is considered an erosive esophagitis without the typical reflux symptoms, but the clinical course and significance of AEE is still unclear.

Aim

We investigated the prevalence and predisposing factors of AEE, and tried to determine its clinical features and significance.

Methods

Subjects, who had at least two health inspections (upper endoscopy, self-reporting questionnaire, and serum Helicobacter pylori IgG antibody test) at our center, were enrolled. The questionnaire included typical reflux symptoms, previous medical history, underlying disease, smoking, alcohol intake, and medication history. Based on the results of follow-up study, the changes in endoscopic findings and reflux symptoms were also investigated.

Results

Of the 2961 patients visiting our clinic, 568 (19.2 %) were diagnosed with AEE. Age over 50 years, male sex, a body mass index over 25, current smoking, heavy drinking, negativity for H. pylori infection, and hiatal hernia were independent predisposing factors for AEE (p = 0.020, p < 0.001, p < 0.001, p = 0.013, p = 0.003, p < 0.001, p = 0.038, respectively). Within the follow-up period (mean 25 ± 9.5 months), reflux symptoms developed in 30 subjects (7.9 %), and current smoking was the only risk factor for the development of AEE symptoms (p = 0.015). On the follow-up endoscopy, erosive esophagitis disappeared in nearly half of the subjects with AEE (174, 45.6 %).

Conclusions

AEE is common, but many cases of AEE may be spontaneously cured without treatment. Although symptom development is rare, quitting smoking may be helpful as a prevention strategy.

Clinical Trial Registration Number

KCT0001716.

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Abbreviations

AEE:

Asymptomatic erosive esophagitis

GERD:

Gastroesophageal reflux disease

BMI:

Body mass index

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Authors’ contributions

SPL involved in study concept, designed and analyzed the data, and drafted the manuscript; IKS was responsible for study concept, interpreted, and drafted the manuscript; JHK, SYL, HSP, and CSS involved in acquisition of data and critical revision of the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Digestive Disease Centre, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Korea

    Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park & Chan Sup Shim

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  1. Sang Pyo Lee
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  2. In-Kyung Sung
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  3. Jeong Hwan Kim
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  4. Sun-Young Lee
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Corresponding author

Correspondence to In-Kyung Sung.

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Ethical approval

The study protocol was approved by the Institutional Review Board of Konkuk University Medical Center (KUH1010716).

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Lee, S.P., Sung, IK., Kim, J.H. et al. The Clinical Features and Predisposing Factors of Asymptomatic Erosive Esophagitis. Dig Dis Sci 61, 3522–3529 (2016). https://doi.org/10.1007/s10620-016-4341-9

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  • DOI: https://doi.org/10.1007/s10620-016-4341-9

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