Clinical Characteristics of Severe Erosive Esophagitis among Patients with Erosive Esophagitis: A Case-control Study

Abstract

Objective The risk factors associated with severe erosive esophagitis are not well defined in Japan. We aimed to evaluate the risk factors associated with the endoscopic severity of esophageal mucosal injury. Methods Eighty consecutive Japanese patients with severe erosive esophagitis [Los Angeles (LA) classification grade C or D] who had undergone upper endoscopies in the Gastroenterology Division of Omori Red Cross Hospital between June 2010 and March 2013 were retrospectively analyzed. For each case, a control with mild erosive esophagitis (LA classification grade A or B) who was matched by sex and age was randomly selected during the same period. Among the endoscopic findings, the condition of the gastroesophageal flap valve (GEFV) was graded according to Hill's classification. We identified the risk factors for severe erosive esophagitis using a multivariable logistic regression model. Results A poor performance status (PS) (odds ratio [OR]=17.1201, 95% confidence interval [CI]=3.0268-140.3121, p=0.0008) and an abnormal GEFV (OR=3.0176, 95% CI=1.0589-9.4939, p=0.0385) were risk factors for severe erosive esophagitis, while the presence of open-type gastric mucosal atrophy (GMA) was inversely associated with severe erosive esophagitis (OR=0.2772, 95% CI=0.1087-0.6675, p=0.0040). Conclusion Among patients with erosive esophagitis, a poor PS and an abnormal GEFV were associated while GMA was inversely associated with severe erosive esophagitis. Drug therapy alone or in combination with physical therapy may improve the therapeutic effect on severe erosive esophagitis in patients with a poor PS.

Clinically significant stigmas of the severity of GERD and dissociation with the degree of damage to the esophageal mucosa — the obligatory esophagoprotection?

“…ГПОД является фактором прогрессирования ГЭРБ и имеет прямую связь с эрозивным эзофагитом. Полученные результаты подтверждаются исследованиям зарубежных коллег, продемонстрировавшим более высокую распространенность и более тяжелое течение эрозивного эзофагита у лиц с ГПОД [24].…”

The Author's Reply: Comment on: Clinical Characteristics of Severe Erosive Esophagitis among Patients with Erosive Esophagitis: A Case-control Study

“…The Authors Reply We thank Khazaei, Mansori and Veisani for their interest in our article ( 1 ). We read their Letters to the Editor in Internal Medicine ( 2 ) and now pen our response.…”

Comment on: Clinical Characteristics of Severe Erosive Esophagitis among Patients with Erosive Esophagitis: A Case-control Study

“…We read the article written by Ida et al published in the Internal Medicine ( 1 ). The authors' aim was to evaluate the risk factors associated with the endoscopic severity of esophageal mucosal injury ( 1 ).…”

“…We read the article written by Ida et al published in the Internal Medicine ( 1 ). The authors' aim was to evaluate the risk factors associated with the endoscopic severity of esophageal mucosal injury ( 1 ). Their results showed that a poor performance status (PS) [odds ratio (OR)=17.1, 95% confidence interval (CI)=3.0268-140.3121, p=0.0008] and an abnormal gastroesophageal flap valve (GEFV) (OR=3.02, 95% CI=1.06-9.5, p=0.04) were risk factors for severe erosive esophagitis.…”