Abstract
Since panendoscopy was introduced on upper gastrointestinal examination, reflux esophagitis has been frequently noticed. The early stage of reflux esophagitis has been observed and recorded since emergent endoscopy became popular. To clarify the pathogenesis of reflux esophagitis, especially that of the erosive and/or ulcerative type, clinical and endoscopical findings were investigated. Materials and method : One hundred and twenty three cases of erosive and/or ulcerative esophagitis were experienced from January 1982 to March 1986. They were devided into 6 groups according to sex (male or female) and age (under 39 years old, 40-59 years old, over 60 years old). Incidence of clinical symptoms (dysphagia, heartburn, abdominal pain and vomiting), cardiac insufficiency, association of peptic ulcer, favorite foods obtained through a questionnaire and combined diseases apart from peptic ulcer were studied and each result was compared with that of 2051 cases (control group) denied esophagitis endoscopically. During the above period, endoscopic follow-up study was made in 27 cases. Results : Patients with erosive and/or ulcerative esophagitis commonly complained dysphagia, heartburn or vomiting irrespective of age, whereas in the control groups the incidence of those symptoms decreased with age. The endoscopical cardiac insufficiency was frequently accompanied with erosive and/or ulcerative esophagitis in every age groups. Especially in male patients under 39 years old and from 40 to 59 years old, both mild and severe cardiac insufficiency were accompanied more frequently than control groups (P<0.05, P<0.05 for mild and P<0.01, P<0.01 for severe). Duodenal ulcers were more frequently noted in male under 39 years old and from 40 to 59 years old, and in female over 60 years old than in control groups (P <0.01, P <0.01, P <0.01). Gastric ulcers were also noted as frequent as duodenal ulcers in both male and female from 40 to 59 years old. In most of the cases, ulcers were in active stage. Among 27 cases followed-up endoscopically, 24 cases improved within two months and 1 case within three months. Two of 25 cases improved within three months showed recurred inflammation several times a year. Two of 27 cases did not improve within three months, and were associated with resistant peptic ulcers. Conclusion : Erosive and/or ulcerative esophagitis showed characteristic symptoms and clearly and significantly related to cardiac insufficiency, peptic ulcer and some favorites of the patients.
