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Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study.
Eur J Gastroenterol Hepatol 2004; 16(5):495-501EJ

Abstract

OBJECTIVE

To determine the prevalence of and risk factors for gastro-oesophageal reflux disease (GORD), reflux oesophagitis and non-erosive reflux disease (NERD) amongst Malaysian patients undergoing upper gastrointestinal endoscopic examination.

DESIGN

A cross-sectional study on consecutive patients with dyspepsia undergoing upper gastrointestinal endoscopy.

SETTING

A large general hospital in Kuala Lumpur, Malaysia.

PARTICIPANTS

Consecutive patients undergoing endoscopy for upper abdominal discomfort were examined for the presence of reflux oesophagitis, hiatus hernia and Barrett's oesophagus. The diagnosis and classification of reflux oesophagitis was based on the Los Angeles classification. Patients with predominant symptoms of heartburn or acid regurgitation of at least one per month for the past 6 months in the absence of reflux oesophagitis were diagnosed as having NERD. The prevalence of GORD, reflux oesophagitis and NERD were analysed in relation to age, gender, race, body mass index (BMI), presence of hiatus hernia, Helicobacter pylori status, alcohol intake, smoking and level of education.

RESULTS

One thousand patients were studied prospectively. Three hundred and eighty-eight patients (38.8%) were diagnosed as having GORD based on either predominant symptoms of heartburn and acid regurgitation and/or findings of reflux oesophagitis. One hundred and thirty-four patients (13.4%) had endoscopic evidence of reflux oesophagitis. Two hundred and fifty-four (65.5%) were diagnosed as having NERD. Hiatus hernia was found in 6.7% and Barrett's oesophagus in 2% of patients. Of our patients with reflux oesophagitis 20.1% had grade C and D oesophagitis. No patients had strictures. Following logistic regression analysis, the independent risk factors for GORD were Indian race (odds ratio (OR), 3.25; 95% confidence interval (CI), 2.38-4.45), Malay race (OR, 1.67; 95% CI, 1.16-2.38), BMI > 25 (OR, 1.41; 95% CI, 1.04-1.92), presence of hiatus hernia (OR, 4.21; 95% CI, 2.41-7.36), alcohol consumption (OR, 2.42; 95% CI, 1.11-5.23) and high education level (OR, 1.52; 95% CI, 1.02-2.26). For reflux oesophagitis independent the risk factors male gender (OR, 1.64; 95% CI, 1.08-2.49), Indian race (OR, 3.25; 95% CI, 2.05-5.17), presence of hiatus hernia (OR, 11.67; 95% CI, 6.40-21.26) and alcohol consumption (OR, 3.22; 95% CI, 1.26-8.22). For NERD the independent risk factors were Indian race (OR, 3.45; 95% CI, 2.42-4.92), Malay race (OR, 1.80; 95% CI, 1.20-2.69), BMI > 25 (OR, 1.47; 95% CI, 1.04, 2.06) and high education level (OR, 1.66; 95% CI, 1.06-2.59).

CONCLUSIONS

Reflux oesophagitis and Barrett's oesophagus were not as uncommon as previously thought in a multiracial Asian population and a significant proportion of our patients had severe grades of reflux oesophagitis. NERD, however, still constituted the larger proportion of patients with GORD. Indian race was consistently a significant independent risk factor for reflux oesophagitis, NERD and for GORD overall.

Authors+Show Affiliations

Division of Gastroenterology, Dept of Medicine, University of Malaya, Kuala Lumpur, Malaysia.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15097043

Citation

Rosaida, Modh Said, and Khean-Lee Goh. "Gastro-oesophageal Reflux Disease, Reflux Oesophagitis and Non-erosive Reflux Disease in a Multiracial Asian Population: a Prospective, Endoscopy Based Study." European Journal of Gastroenterology & Hepatology, vol. 16, no. 5, 2004, pp. 495-501.
Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol. 2004;16(5):495-501.
Rosaida, M. S., & Goh, K. L. (2004). Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. European Journal of Gastroenterology & Hepatology, 16(5), pp. 495-501.
Rosaida MS, Goh KL. Gastro-oesophageal Reflux Disease, Reflux Oesophagitis and Non-erosive Reflux Disease in a Multiracial Asian Population: a Prospective, Endoscopy Based Study. Eur J Gastroenterol Hepatol. 2004;16(5):495-501. PubMed PMID: 15097043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. AU - Rosaida,Modh Said, AU - Goh,Khean-Lee, PY - 2004/4/21/pubmed PY - 2004/7/24/medline PY - 2004/4/21/entrez SP - 495 EP - 501 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 16 IS - 5 N2 - OBJECTIVE: To determine the prevalence of and risk factors for gastro-oesophageal reflux disease (GORD), reflux oesophagitis and non-erosive reflux disease (NERD) amongst Malaysian patients undergoing upper gastrointestinal endoscopic examination. DESIGN: A cross-sectional study on consecutive patients with dyspepsia undergoing upper gastrointestinal endoscopy. SETTING: A large general hospital in Kuala Lumpur, Malaysia. PARTICIPANTS: Consecutive patients undergoing endoscopy for upper abdominal discomfort were examined for the presence of reflux oesophagitis, hiatus hernia and Barrett's oesophagus. The diagnosis and classification of reflux oesophagitis was based on the Los Angeles classification. Patients with predominant symptoms of heartburn or acid regurgitation of at least one per month for the past 6 months in the absence of reflux oesophagitis were diagnosed as having NERD. The prevalence of GORD, reflux oesophagitis and NERD were analysed in relation to age, gender, race, body mass index (BMI), presence of hiatus hernia, Helicobacter pylori status, alcohol intake, smoking and level of education. RESULTS: One thousand patients were studied prospectively. Three hundred and eighty-eight patients (38.8%) were diagnosed as having GORD based on either predominant symptoms of heartburn and acid regurgitation and/or findings of reflux oesophagitis. One hundred and thirty-four patients (13.4%) had endoscopic evidence of reflux oesophagitis. Two hundred and fifty-four (65.5%) were diagnosed as having NERD. Hiatus hernia was found in 6.7% and Barrett's oesophagus in 2% of patients. Of our patients with reflux oesophagitis 20.1% had grade C and D oesophagitis. No patients had strictures. Following logistic regression analysis, the independent risk factors for GORD were Indian race (odds ratio (OR), 3.25; 95% confidence interval (CI), 2.38-4.45), Malay race (OR, 1.67; 95% CI, 1.16-2.38), BMI > 25 (OR, 1.41; 95% CI, 1.04-1.92), presence of hiatus hernia (OR, 4.21; 95% CI, 2.41-7.36), alcohol consumption (OR, 2.42; 95% CI, 1.11-5.23) and high education level (OR, 1.52; 95% CI, 1.02-2.26). For reflux oesophagitis independent the risk factors male gender (OR, 1.64; 95% CI, 1.08-2.49), Indian race (OR, 3.25; 95% CI, 2.05-5.17), presence of hiatus hernia (OR, 11.67; 95% CI, 6.40-21.26) and alcohol consumption (OR, 3.22; 95% CI, 1.26-8.22). For NERD the independent risk factors were Indian race (OR, 3.45; 95% CI, 2.42-4.92), Malay race (OR, 1.80; 95% CI, 1.20-2.69), BMI > 25 (OR, 1.47; 95% CI, 1.04, 2.06) and high education level (OR, 1.66; 95% CI, 1.06-2.59). CONCLUSIONS: Reflux oesophagitis and Barrett's oesophagus were not as uncommon as previously thought in a multiracial Asian population and a significant proportion of our patients had severe grades of reflux oesophagitis. NERD, however, still constituted the larger proportion of patients with GORD. Indian race was consistently a significant independent risk factor for reflux oesophagitis, NERD and for GORD overall. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/15097043/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=15097043 DB - PRIME DP - Unbound Medicine ER -