Clinical Symptoms in Endoscopic Reflux Esophagitis: Evaluation in 8031 Adult Subjects

Abstract

This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) were classified as positive reflux esophagitis, and 2223 (27.7%) had heartburn, 1522 (19.0%) had dysphagia, 493 (6.1%) had odynophagia, and 1466 (18.3%) had acid regurgitation. Multivariate analysis indicated that the symptom most related to esophagitis was heartburn (odds ratio: 2.46), although approximately 40% of subjects with grade C or D did not complain of heartburn. Regarding the other symptoms, less than 30% subjects with severe esophagitis complained of the symptoms and the odds ratio was approximately 1. These results indicate that endoscopic esophagitis was not equivalent to any reflux symptoms from which subjects suffered in their daily lives.

Incidence of reflux esophagitis and Helicobacter pylori infection in diabetic patients

“…Today, the incidence of RE is reported to be 10%-20% in Europe and the United States [23][24][25] , and 14%-16% in Japan [26][27][28] . While the incidence of RE in Japan is considered low as compared to Europe and the United States, the incidence of RE in Japan has increased due to the westernization of the Japanese diet, the rapidly growing elderly population, and lower H pylori infection rates [26][27][28] . Parkman [5] has reported that the incidence of RE in patients was 20% (4/20).…”

“…In Japan, with respect to the severity of RE, most patients are reported to have mild esophagitis (Grade A or B under the Los Angeles classification [26,27] . In the present study, all patients had mild esophagitis.…”

Cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs (etodolac, meloxicam, celecoxib, rofecoxib, etoricoxib, valdecoxib and lumiracoxib) for osteoarthritis and rheumatoid arthritis: a systematic review and economic evaluation

“…Endoscopic abnormalities are more likely in people over 45 years of age. 33,34 Serious UGI events such as perforation or bleeding from gastric or duodenal ulcers occur in up to 2% of NSAID users, with an estimated 2000 deaths annually in the UK. 35 Bleeding and perforation are often not heralded by symptoms 36 and ulcers seen at endoscopy occur in over onequarter of people taking ibuprofen and other nonselective NSAIDs, but less commonly with COX-2 selective NSAIDs.…”

Five-year Follow-up Study of Patients with Reflux Symptoms and Reflux Esophagitis in Annual Medical Check-up Field

“…The majority of patients with reflux symptoms have been reported not to have endoscopically proven erosive esophagitis, even though their symptoms are severe not only in western countries but also in Japan (4)(5)(6)(7)(8)(9)(10)(11)(12). We have recently clarified that 18% of Japanese subjects who attend hospital for annual health check-ups have reflux symptoms or endoscopically proven reflux esophagitis, and that over 80% of patients with reflux symptoms do not have erosive esophagitis (13).…”