Digestive Diseases and Sciences

, Volume 55, Issue 5, pp 1320–1324 | Cite as

Erosive Esophagitis in Asymptomatic Subjects: Risk Factors

  • Fu-Wei Wang
  • Ming-Shium Tu
  • Hung-Yi Chuang
  • Hsien-Chung Yu
  • Lung-Chih Cheng
  • Ping-I Hsu
Original Article

Abstract

Introduction

Asymptomatic erosive esophagitis is a common yet rarely reported disease. The purpose of this study is to investigate the prevalence of asymptomatic erosive esophagitis and to identify the risk factors for this disease.

Materials and Methods

In this study, we investigated 572 asymptomatic subjects undergoing health check-ups after upper gastrointestinal endoscopy. The severity of esophagitis was evaluated by the Los Angeles classification, and the independent risk factors for asymptomatic esophagitis were analyzed by the logistic regression method.

Results

The results showed the prevalence of erosive esophagitis in asymptomatic subjects was 12% (70/572). In all asymptomatic subjects, erosive esophagitis was grade A (71%) or B (29%). Univariate analysis revealed that male gender, high body mass index (BMI), and consumption of tobacco, alcohol, tea, spicy foods, and betel nut were associated with the development of erosive esophagitis. Multivariate analysis revealed that male gender (OR, 3.8, 95% CI, 1.5–9.3) and high BMI (BMI 25–30: OR, 2.3, 95% CI, 1.3–4.2; BMI >30: OR, 3.8, 95% CI, 1.3–10.9) were independent predictors of erosive esophagitis.

Conclusion

Our data revealed male gender and high BMI are independent risk factors for asymptomatic erosive esophagitis.

Keywords

Erosive esophagitis Asymptomatic Endoscopy Health check-up 

References

  1. 1.
    Fass R, Dickman R. Clinical consequences of silent gastroesophageal reflux disease. Curr Gastroenterol Rep. 2006;8:195–201.CrossRefPubMedGoogle Scholar
  2. 2.
    El-Serag HB, Petersen NJ, Carter J, et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004;126:1692–1699.CrossRefPubMedGoogle Scholar
  3. 3.
    Ohara S, Kouzu T, Kawano T, Kusano M. Nationwide epidemiological survey regarding heartburn and reflux esophagitis in Japanese. Jpn J Gastroenterol. 2005;102:1010–1024.Google Scholar
  4. 4.
    Hu WH, Wong WM, Lam CL, et al. Anxiety but not depression determines health care-seeking behaviour in Chinese patients with dyspepsia and irritable bowel syndrome: a population-based study. Aliment Pharmacol Ther. 2002;16:2081–2088.CrossRefPubMedGoogle Scholar
  5. 5.
    Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ 3rd. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102:1259–1268.PubMedGoogle Scholar
  6. 6.
    Kennedy T, Jones R. The prevalence of gastroesophageal reflux symptoms in a UK population and the consultation behaviour of patients with these symptoms. Aliment Pharmacol Ther. 2000;14:1589–1594.CrossRefPubMedGoogle Scholar
  7. 7.
    Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–1920.CrossRefPubMedGoogle Scholar
  8. 8.
    Lagergren J. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–831.CrossRefPubMedGoogle Scholar
  9. 9.
    Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–180.CrossRefPubMedGoogle Scholar
  10. 10.
    Lee SJ, Song CW, Jeen YT, et al. Prevalence of endoscopic reflux esophagitis among Koreans. J Gastroenterol Hepatol. 2001;16:373–376.CrossRefPubMedGoogle Scholar
  11. 11.
    Manabe N, Yoshihara M, Sasaki A, Tanaka S, Haruma K, Chayama K. Clinical characteristics and natural history of patients with low-grade reflux esophagitis. J Gastroenterol Hepatol. 2002;17:949–954.CrossRefPubMedGoogle Scholar
  12. 12.
    Nozu T, Komiyama H. Clinical characteristics of asymptomatic esophagitis. J Gastroenterol. 2008;43:27–31.CrossRefPubMedGoogle Scholar
  13. 13.
    Nocon M, Labenz J, Jaspersen D, et al. Association of body mass index with heartburn, regurgitation and esophagitis: results of the progression of gastroesophageal reflux disease study. J Gastroenterol Hepatol. 2007;22:1728–1731.CrossRefPubMedGoogle Scholar
  14. 14.
    El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005;100:1243–1250.CrossRefPubMedGoogle Scholar
  15. 15.
    Hampell H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143:199–211.Google Scholar
  16. 16.
    El-Serage HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increases oesophageal acid exposure. Gut. 2007;56:749–755.CrossRefGoogle Scholar
  17. 17.
    Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006;354:2340–2348.CrossRefPubMedGoogle Scholar
  18. 18.
    Sheu BS, Chang WL, Cheng HC, Kao AW, Lu CC. Body mass index can determine the healing of reflux esophagitis with Los Angeles Grades C and D by esomeprazole. Am J Gastroenterol. 2008;103:2209–2214.CrossRefPubMedGoogle Scholar
  19. 19.
    Barak N, Ehrenpreis ED, Harrison JR, Sitrin MD. Gastro-oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations. Obes Rev. 2002;3:9–15.CrossRefPubMedGoogle Scholar
  20. 20.
    Wisén O, Rössner S, Johansson C. Gastric secretion in massive obesity. Evidence for abnormal response to vagal stimulation. Dig Dis Sci. 1987;32:968–972.CrossRefPubMedGoogle Scholar
  21. 21.
    Mercer CD, Wren SF, DaCosta LR, Beck IT. Lower esophageal sphincter pressure and gastroesophageal pressure gradients in excessively obese patients. J Med. 1987;18:135–146.PubMedGoogle Scholar
  22. 22.
    Kim N, Lee SW, Cho SI, et al. The prevalence of and risk factors for erosive oesophagitis and non-erosive reflux disease: a nationwide multicentre prospective study in Korea. Aliment Pharmacol Ther. 2007;27:173–185.PubMedCrossRefGoogle Scholar
  23. 23.
    Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;112:1448–1456.CrossRefPubMedGoogle Scholar
  24. 24.
    Adeniyi KO, Olowookorun MO. Influence of sex on gastric acid secretion and parietal cell mass in the rat. Acta Physiol Hung. 1989;4:63–67.Google Scholar
  25. 25.
    Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut. 2004;53:1730–1735.CrossRefPubMedGoogle Scholar
  26. 26.
    Nocon M, Labenz J, Willicj SN. Lifestyle factors and symptoms of gastro-oesophageal reflux—a population-based study. Aliment Pharmacol Ther. 2006;23:169–174.CrossRefPubMedGoogle Scholar
  27. 27.
    Dore MP, Maragkoudakis E, Fraley K, et al. Diet, lifestyle and gender in gastro-oesophageal reflux disease. Dig Dis Sci. 2008;53:2027–2032.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Fu-Wei Wang
    • 1
  • Ming-Shium Tu
    • 1
  • Hung-Yi Chuang
    • 2
    • 3
  • Hsien-Chung Yu
    • 4
  • Lung-Chih Cheng
    • 4
  • Ping-I Hsu
    • 4
  1. 1.Department of Family MedicineKaohsiung Veterans General HospitalKaohsiungTaiwan
  2. 2.Department of Community MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
  3. 3.Faculty of Public HealthKaohsiung Medical UniversityKaohsiungTaiwan
  4. 4.Division of Gastroenterology, Department of Internal MedicineKaohsiung Veterans General HospitalKaohsiungTaiwan

Personalised recommendations