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Erosive Esophagitis in Asymptomatic Subjects: Risk Factors

Digestive Diseases and Sciences volume 55, pages 1320–1324 (2010)Cite this 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.

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References

  1. Fass R, Dickman R. Clinical consequences of silent gastroesophageal reflux disease. Curr Gastroenterol Rep. 2006;8:195–201.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  CAS  PubMed  Google Scholar 

  5. Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ 3rd. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102:1259–1268.

    CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  8. Lagergren J. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–831.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  10. Lee SJ, Song CW, Jeen YT, et al. Prevalence of endoscopic reflux esophagitis among Koreans. J Gastroenterol Hepatol. 2001;16:373–376.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  12. Nozu T, Komiyama H. Clinical characteristics of asymptomatic esophagitis. J Gastroenterol. 2008;43:27–31.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. El-Serage HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increases oesophageal acid exposure. Gut. 2007;56:749–755.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    PubMed  Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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Conflict of Interest Disclosure

The authors have no conflicts of interest to declare.

Financial Support

The authors have received no funding and confirm there were no financial arrangements that could influence this study.

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Affiliations

  1. Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Fu-Wei Wang & Ming-Shium Tu

  2. Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Hung-Yi Chuang

  3. Faculty of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan

    Hung-Yi Chuang

  4. Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 st Road, Kaohsiung, 80424, Taiwan

    Hsien-Chung Yu, Lung-Chih Cheng & Ping-I Hsu

Authors
  1. Fu-Wei Wang
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  2. Ming-Shium Tu
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  3. Hung-Yi Chuang
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  4. Hsien-Chung Yu
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  5. Lung-Chih Cheng
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  6. Ping-I Hsu
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Correspondence to Ping-I Hsu.

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Wang, FW., Tu, MS., Chuang, HY. et al. Erosive Esophagitis in Asymptomatic Subjects: Risk Factors. Dig Dis Sci 55, 1320–1324 (2010). https://doi.org/10.1007/s10620-009-0888-z

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  • DOI: https://doi.org/10.1007/s10620-009-0888-z

Keywords

  • Erosive esophagitis
  • Asymptomatic
  • Endoscopy
  • Health check-up