Different risk factors between reflux symptoms and mucosal injury in gastroesophageal reflux disease

Abstract

Gastroesophageal reflux disease (GERD) is diagnosed based on typical symptoms in clinical practice. It can be divided into two groups using endoscopy: erosive and nonerosive reflux disease (NERD). This study aims to determine the risk factors of reflux symptoms and mucosal injury. This was a two-step case-control study derived from a cohort of 998 individuals having the data of reflux disease questionnaire (RDQ) and endoscopic findings. Those with minor reflux symptoms were excluded. The first step compared symptomatic GERD patients with healthy controls. The 2(nd) step compared patients with erosive esophagitis with healthy controls. In this study, the prevalence of symptomatic GERD and erosive esophagitis were 163 (16.3%) and 166 (16.6%), respectively. A total of 507 asymptomatic individuals without mucosal injury of the esophagus on endoscopy were selected as healthy controls. Compared with healthy controls, multivariate analyses showed that symptomatic GERD patients had a higher prevalence of hypertriglyceridemia [odds ratio (OR), 1.83; 95% confidence interval (CI) 1.13-2.96] and obesity (OR, 1.85; 95% CI 1.08-3.02). By contrast, male sex (OR, 2.24; 95% CI 1.42-3.52), positive Campylo-like organism (CLO) test (OR, 0.56; 95% CI 0.37-0.84), and hiatus hernia (OR, 14.36; 95% CI 3.05-67.6) were associated with erosive esophagitis. In conclusion, obesity and hypertriglyceridemia were associated with reflux symptoms. By contrast, male sex, negative infection of Helicobacter pylori, and hiatus hernia were associated with mucosal injury. Our results suggested that risk factors of reflux symptoms or mucosal injury might be different in GERD patients. The underlying mechanism awaits further studies to clarify.

The role of tea and coffee in the development of gastroesophageal reflux disease

“…However, the therapeutic response is still unsatisfactory especially for those patients with nonacidic reflux or esophageal hypersensitivity. Research on new compounds and identifying the risk factors of GERD would be helpful in the treatment of refractory GERD [91011].…”

Clinical and Endoscopic Evaluation in Patients With Gastroesophageal Symptoms

“…In the ProGERD study (18) alcohol and tobacco were predictors of severe esophagitis (Los Angeles C and D). In contrast, other studies found no differences between EE and non-EE groups (8,23) . In the present study alcohol and tobacco use was slightly more prevalent in the EE group but it lacks significance, possible due small sentence and underreport.…”

“…This finding was consistent with the ProGERD (18) , which evaluated the influence of hypertension, coronary disease, circulatory changes, diabetes, lung and inflammatory diseases in two forms of GERD. Li et al (23) also evaluated the participation of hypertriglyceridemia, hypercholesterolemia, low levels of HDL, high levels of LDL and glycated hemoglobin, and found no statistical difference between the groups. This same study did not consider the use of NSAIDs/ASA as a predictor of EE.…”

Risk factors for gastroesophageal reflux disease and analysis of genetic contributors

“…Additionally, several other factors have been asserted as causes of heartburn symptoms. Metabolic syndrome or its components- and especially hypertriglyceridemia- have been associated with erosive esophagitis or reflux symptoms respectively[ 34 ]. Zheng et al[ 21 ] found that a dose-dependent smoking was linked to the occurrence of gastroesophageal reflux symptoms with a risk of about 37% risk among women and 53% among men.…”