Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly

Amano, Kazutoshi; Adachi, Kyoichi; Katsube, Tomoko; Watanabe, Makoto; Kinoshita, Yoshikazu

doi:10.1046/j.1440-1746.2001.02408.x

Cited by 103 publications

(107 citation statements)

References 26 publications

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“…We are unable to explain the discrepancy in the chronological changes in the diaphragmatic hiatus and BMI observed in our female subjects, and further studies are needed to clarify the factors involved. Aging may have some role in increasing the size of the diaphragmatic hiatus in our study subjects, since an age-related increase in the incidence of hiatal hernia has been previously demonstrated in women (2,3).…”

Section: Discussionmentioning

confidence: 85%

“…GERD is influenced by multiple factors, including gastric acid secretion, hiatal hernia, the lower esophageal sphincter function, esophageal motility, esophageal perception and others (1,(3)(4)(5)28). The prevalence of GERD has increased among Asian populations in recent decades, and the increment in the rate of GERD in Asians is thought to be caused by several factors.…”

Section: Discussionmentioning

confidence: 99%

“…GERD has been becoming more prevalent in Asian populations in recent decades, and although the disease is considered to be a common disorder in both Western and Asian populations, its increasing prevalence in Asia may be due to multiple factors, such as the Westernization of eating habits, decrease in the rate of Helicobacter pylori infection, increased gastric acid secretion and a larger elderly population, as well as other factors (2)(3)(4)(5)(6)(7)(8)(9). High intra-abdominal pressure caused by abdominal fat accumulation has been demonstrated to increase the gastroesophageal pressure gradient and incidence of gastroesophageal reflux, while obesity and a high body mass index (BMI) have repeatedly been reported to be correlated with a high prevalence of reflux esophagitis and symptoms of GERD (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

et al. 2015

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Objective Obesity is related to an increased prevalence of reflux esophagitis and gastroesophageal reflux disease symptoms. This study was performed to clarify the influence of gender on time-course changes in the rate of a high BMI and incidence of reflux esophagitis in Japanese subjects. Results A multiple logistic regression analysis showed that a high BMI, milder degree of gastric mucosal atrophy and larger size of diaphragmatic hiatus were significant predictive factors for the presence of reflux esophagitis in both men and women. The number of male subjects with reflux esophagitis and a high BMI increased during the 10-year examination period. In contrast, the number of individuals with reflux esophagitis and a high BMI was not increased among women. For both men and women, the proportions of patients with a large diaphragmatic hiatus and mild gastric mucosal atrophy increased during the 10-year period. Conclusion The prevalence of reflux esophagitis in the female subjects remained constant over 10 years, different from that observed in the men. A lack of change in BMI may be an important factor accounting for the constant prevalence of reflux esophagitis in women.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

et al. 2015

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“…Diagnosis and classification of reflux esophagitis were based on the Los Angeles classification [8] . Barrett's esophagus was diagnosed when columnar epithelium was seen to extend the Z line and confirmed histologically that showed specialized intestinal metaplasia.…”

Section: Upper Gastrointestinal Endoscopymentioning

confidence: 99%

“…Although many investigators have reported the prevalence of erosive esophagitis [8] , the prevalence of NERD has not been investigated in China. Our study was designed to analyze the spectrum of GERD subjects based on presenting symptoms and endoscopic findings.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for gastroesophageal reflux disease, reflux esophagitis and non-erosive reflux disease among Chinese patients undergoing upper gastrointestinal endoscopic examination

Juan¹,

Du²,

Jiang³

et al. 2007

WJG

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AIM:To analyze the spectrum and risk factors of gastroesophageal reflux disease (GERD) based on presenting symptoms and endoscopic findings. METHODS:A cross-sectional survey in a cluster random sample was conducted from November 2004 to June 2005 using a validated Chinese version Reflux Disease Questionnaire (RDQ) and other items recording the demographic characteristics and potential risk factors for GERD. Subjects were defined as having GERD symptoms according to the RDQ score (> 12). All subjects were endoscopied and the definition and severity of erosive esophagitis were evaluated by Los Angeles classification. The statistical analysis was performed with SPSS13.0 programs. RESULTS:Of 2231 recruited participants, 701 (31.40%) patients were diagnosed as having GERD while 464 (20.80%) patients had objective findings of reflux esophagitis (RE). Of those 464 patients, only 291 (13.00%) were reported as subjects with GERD symptoms. A total of 528 (23.70%) patients were found to have GERD symptoms, including 19.50% patients with grade A or B reflux esophagitis, 0.90% with grade C and 0.40% with grade D. On multivariate analysis, old age, male, moderate working burden, divorced/widowed and strong tea drinking remained as significant independent risk factors for erosive esophagitis. Meanwhile, routine usage of greasy food and constipation were considered as significant independent risk factors for non-erosive reflux disease (NERD). CONCLUSION:GERD is one of the common GI diseases with a high occurrence rate in China and its main associated factors include sex, anthropometrical variables and sociopsychological characteristics.

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Endoscopic findings of cardiac lymphoid hyperplasia and Helicobacter pylori infection status

et al. 2021

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Objective Lymphoid hyperplasia is endoscopically observed as multiple small whitish round nodules or spots. This retrospective study was performed to examine the prevalence of that finding in patients with Barrett's epithelium and its relationship with the status of H. pylori infection. Methods The study subjects were 3353 patients (males 2186, females 1167; mean age 55.2 ± 9.4 years) in whom the status of H. pylori infection had been determined. The presence of Barrett's epithelium ≥ 5 mm in length was endoscopically determined, and then endoscopic observations with blue laser imaging were used to investigate the presence of lymphoid hyperplasia in those areas. Results Barrett's epithelium was diagnosed in 1884 (56.2%) of the subjects, and endoscopic findings of lymphoid hyperplasia were observed in 402 (21.3%) of those with Barrett's epithelium. Lymphoid hyperplasia in Barrett's epithelium was not present in any without a current or prior H. pylori infection, while the prevalence of lymphoid hyperplasia in H. pylori ‐positive and post‐eradicated subjects was 48.4% and 30.4%, respectively ( p < 0.001). Multiple logistic regression analysis revealed that female gender, younger age, and higher degree of gastric mucosal atrophy were significant factors related to lymphoid hyperplasia positivity. In addition, the duration after H. pylori eradication was negatively correlated with its prevalence. Conclusion Endoscopic findings of cardiac lymphoid hyperplasia were well correlated with H. pylori infection, although prevalence decreased over time following bacterial eradication.

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Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly

Abstract: Aging, male gender, HH and closed-type GMA are most likely the risk factors of endoscopically proven reflux esophagitis in Japanese patients.

Cited by 103 publications

References 26 publications

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

Gender Differences in the Time-Course Changes of Reflux Esophagitis in Japanese Patients

Risk factors for gastroesophageal reflux disease, reflux esophagitis and non-erosive reflux disease among Chinese patients undergoing upper gastrointestinal endoscopic examination

Endoscopic findings of cardiac lymphoid hyperplasia and Helicobacter pylori infection status

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