Gastroscopic Clinical Characteristics Of 3652 Reflux Esophagitis Patients

Background And AimGastroesophageal Reflux Disease (GERD) is a common disease of the digestive system in China. Among which, Reflux Esophagitis (RE) refers reflux materials enter into the esophagus, causing mucosal damage, such as erosions and ulcers. Recent studies have found the prevalence of RE in China showed an upward trend.The main purpose of this study is to explore the association between gender, age, Helicobacter pylori (Hp), bile reflux, atrophic gastritis, esophageal hiatal hernia, duodenal ulcer and other factors with the severity of RE through the retrospective analysis of endoscopic data of patients who had a upper gastrointestinal endoscopy and diagnosed as RE at Qilu Hospital of Shandong University.Methods1.Patients selection:Patients included in this study had a upper gastrointestinal endoscopy between March 2012 and December 2015 at Qilu Hospital of Shandong University, who were diagnosed as RE.3652 cases were selected. Diagnostic criteria of RE refers Los Angeles classification. Hp infection refers rapid urease test.2.Collection of endoscopic data:Gender, age, Hp infection, RE classification and the incidence of bile reflux, atrophic gastritis, esophageal hiatal hernia, duodenal ulcer and other complication were gathered and analyzed.3.Statistical analysis:The statistical analysis of the data in this study using Excel 2011 and SPSS 21.0. P<0.05 was considered statistically significant.Results1.The study included 3652 cases of RE patients,7.03% of the total number of endoscopy in the same period. In which, A, B, C, D grade RE patients, respectively, accounting for 39.70%,50.11%,6.52%,3.67%. The average age was 53.54±12.64 (11,88). Male 2760 cases, female 892 cases, the gender ratio was 3.09:1. Hp positive rate was 19.95%.2.From 2012 to 2015 at Qilu Hospital of Shandong University, RE detection rate rose, and the gender ratio decreased.RE patients were divided in to two groups:the mild lever including A, B grade and moderate to severe level including C, D grade. The results are as follows:3. Average age of mild RE group was 53.08±12.50, average age of moderate to severe RE group was 57.61±13.10, statistically significant (p<0.001).Mild RE patients compared with moderately to severe RE patients, the incidence of combination of atrophic gastritis is higher, with statistical significance (p<0.001).Moderately to severe RE patients compared with mild RE patients, the incidence of combination of gastric cancer(p<0.001), esophageal ulcers(p<0.001), esophageal stenosis(p<0.001), gastroesophageal surgery(p<0.001), hiatal hernia(p<0.001), duodenal ulcers(p=0.031) is higher, with statistical significance.4. Regression analysis results:Atrophic gastritis (OR=0.654, p=0.010) is negatively related to the RE severity. Age (OR=1.359, p<0.001), gastric cancer (OR =2.767, p<0.001), esophageal ulcer (OR=6.481, p<0.001), esophageal stenosis (OR= 9.281, p=0.014), hiatal hernia (OR=4.340, p<0.001), gastroesophageal surgery (OR=7.524, p< 0.001), duodenal ulcer (OR=2.314, p<0.001) are positively related to the RE severity.Conclusions1. Increasing age, gastric cancer, hiatal hernia, gastroesophageal surgery, duodenal ulcer, may be risk factors for aggravating RE severity.2. Atrophic gastritis may be protective factor for aggravating RE severity.3. The incidence of esophageal stenosis and RE severity is closely related.To understand RE patient’s severity contributes to early treatment to prevent stenosis.