| BackgroundGERD is one of the most common diseases of the GIT tract around the globe.The prevalence of GERD has increased worldwide in the recent years, especially inthe developing countries ranging from10%to48%. The common symptoms ofGERD are heart burn (retrosternal burning), epigastric pain, dysphagia,acid reflux, morning hoarseness, and so on. Heartburn was found to be achief complaint for GERD in East Asia countries. Endoscopy is usuallyperformed to diagnose reflux esophagitis and its severity. However,endoscopic examination does not show any abnormality in some patientpresenting with symptom of GERD. These patients are said to be sufferingfrom “endoscopy-negative reflux disease”. The main aim of physicians andgastroenterologist worldwide is to get rid of the symptoms of GERD and prevent complications, such as esophageal strictures, gastrointestinal bleeding and Barrett’sesophagus. However, as a matter of fact, there should also be consensus to evaluatethe risk factors that precipitate GERD symptom and to prevent the high prevalenceof endoscopic–negative GERD. Smoking, alcohol, overweight (obesity)and poorquality of sleep are some of the significant risk-factors for GERD.ObjectiveTo develop a criterion for performing endoscopy in patient with symptoms ofGERD, to study the correlation between RE and NERD and the risk factorsassociated with reflux esophagitis (RE).DesignAn observational, cross-sectional study.Place and Duration of Study The study was conducted at the Endoscopic center of First Hospital of JilinUniversity, Changchun, China from September1,2012to November30,2012.Patients and MethodsPatients referred to endoscopy center by the attending medicalofficer/gastroenterologist in out-patient department due to bothersome GERDsymptoms were inducted in the study. Patients complaining of heartburn and/oracid reflux atleast once a week for greater than3months were diagnosed withsymptomatic GERD. Patients who did not have a previous history of undergoingesophagogastroduodenoscopy (EGD) were then asked to fill “GERD SeverityQuestionnaire”, which recorded frequency of GERD symptoms in the previousweek and the potent risk factors associated with GERD. After filling theQuestionnaire, all patients underwent EGD. The GERD severity score (GSS) andendoscopic findings for each patient were recorded. ResultsA total of70patients met the inclusion criteria during the study period. There were30males (42.9%) and40females (57.1%).42(60%) patients had were diagnosedwith NERD while28(40%) patients were diagnosed with reflux esophagitis afterperforming EGD. GSS≥8in symptomatic GERD patients was found to bestatistically significant for performing EGD (p<0.001;x^2=34.6). Heartburn wasthe most common presenting symptom in65(92.86%) patients followed by acidreflux in64(91.42%) patients. Using logistic regression analysis, positivepredictive risk factors for developing reflux esophagitis were male gender OR,4.50;95%CI1.68-12.51, smoking (1packet/day)OR,6.76;95%CI2033-19.86, Alcoholconsumption(>500ml/day)OR3.78;95%CI1.22-11.75and BMI>25OR,6.23;95%CI,1.98-19.62.Conclusion NERD is common among symptomatic GERD patients. A GERD severityQuestionnaire may aid physicians to decide if performing endoscopy is mandatoryon symptomatic GERD patients to prevent its complications. Male gender, alcohol,cigarette smoking and body mass index (BMI)>25were significant risk factors fordeveloping reflux esophagitis. |
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