Abstract
BACKGROUND AND AIMS: The prevalence of reflux esophagitis which might be a risk factor for Barrett’s esophagus has been increasing in Japan. Therefore it is essential to identify the risk factors for reflux esophagitis. We examined the backgrounds of general medical checkup examinees to analyze the risk factors for reflux esophagitis.
METHODS: We studied the result of esophagogastroduodenoscopy on 1,062 subjects (680 males and 382 females; mean age 55.3) in general medical checkup examinees from April 2015 to March 2016. Two hundred and twenty subjects (20.7%) had reflux esophagitis classified as Los Angeles grade A-D. The χ2 test was calculated for the frequency difference of nine background factors for the patients and those without the disease. Logistic regression analysis was performed to evaluate the risk factors for reflux esophagitis.
RESULTS: Reflux esophagitis was more frequent in males than females (27.6 vs. 8.4%). Although in males, the incidence of reflux esophagitis in the group under 60 years old was higher than in the group over 60 years old, there were no statistically significant differences between the two age groups in females. The prevalence of six background factors: Male gender, 0besity, Drinking, Smoking, Gastric mucosal atrophy (Kimura · Takemoto C-0 and C-1), and Hiatus hernia, were significantly higher in patients of esophagitis than those without the disease. Multivariate logistic regression analyses revealed that hiatus hernia (OR 3.4), male gender (OR 3.3), obesity (OR 1.8), age under 60 years old (OR 1.7) were significant positive risk factors while gastric mucosal atrophy of C-0 and C-1 was not.
CONCLUSIONS: The result of no statistically significant differences between age groups in females differed from previous studies. To analyze significant risk of gastric mucosa without atrophy for reflux esophagitis, moderate-severe mucosal atrophy above C-3 with decreased gastric acid secretion, should have been used as control group. Endoscopically checking for hiatus hernia is essential to prevent onset of reflux esophagitis. Also consideration of gender difference, age and prevention of obesity are important.
