Clinical Spectrum of Reflux Esophagitis Among 25,536 Koreans Who Underwent a Health Check-up

Shim, Ki Nam; Hong, Su Jin; Sung, Jae Kyu; Park, Kyung Sik; Kim, Seong Eun; Park, Hyun Shin; Kim, Young Sun; Lim, Seon Hee; Kim, Chung Hyeon; Park, Min Jung; Yim, Jeong Yoon; Cho, Kyung Ran; Kim, Dong‐Hee; Park, Seun Ja; Jee, Sam Ryong; Kim, Sang Hyun; Park, Joon Yong; Song, Geun Am; Jung, Hwoon Yong; Lee, Yong Chan; Kim, Jae Gyu; Kim, Jae J.; Kim, Nayoung; Park, Soo Heon; Jung, Hyun Chae; Chung, In Sik

doi:10.1097/mcg.0b013e3181855055

Cited by 34 publications

(35 citation statements)

References 55 publications

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“…8,36 On the other hand, the grade of esophagitis by esophagogastroduodenoscopy and the time period at pH below 4 during ambulatory 24-hour esophageal pH monitoring did not show any significant differences between men and women. 8,36 In a multicenter study performed in Korea in 2006 with 25 536 subjects who received esophagogastroduodenoscopic examination for medical check-up, the prevalence of reflux esophagitis was significantly higher in men (11.2%) than in women (3.1%) (P < 0.0001), 34 GERD symptoms* which was similar to the results in a 2011 nationwide multicenter study. 30 Moreover, the degree of esophagitis was more severe in males than in females.…”

Section: Endoscopy-based Studysupporting

confidence: 73%

“…30 Moreover, the degree of esophagitis was more severe in males than in females. 34 However, the percentage of women having NERD (5%) was higher than that of men having NERD (3%).…”

Section: Endoscopy-based Studymentioning

confidence: 80%

“…9,[26][27][28][29][30][31][32][33][34][35][36][37][38] A meta-analysis has described that the men/women ratio in the prevalence of reflux esophagitis was 1.57 (95% CI, 1.40-1.76) and the mean age of men with reflux esophagitis was lower than that of women. 7 In a systematic review based on data of 67 056 patients using the PubMed database between 1997 and 2011 (including 12 unbiased population-based studies, 8 studies from Asian countries, 2 studies from Europe, and 1 study from the US), the prevalence of reflux esophagitis was lower in women compared to that men (women: 6.1 ± 1.6%, range: 2.1-16.8%; men: 15.9 ± 2.5%, range: 7.0-28.1%; P < 0.01).…”

Section: Endoscopy-based Studymentioning

confidence: 99%

“…21 In contrast, NERD is more common in women. 2,7,15,16,34,39 A quantitative analysis of esophageal symptoms has showed that the symptom frequency and severity were significantly higher in women than in men. 8,36 On the other hand, the grade of esophagitis by esophagogastroduodenoscopy and the time period at pH below 4 during ambulatory 24-hour esophageal pH monitoring did not show any significant differences between men and women.…”

Section: Endoscopy-based Studymentioning

confidence: 99%

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Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

Self Cite

125

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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Section: Endoscopy-based Studysupporting

confidence: 73%

“…30 Moreover, the degree of esophagitis was more severe in males than in females. 34 However, the percentage of women having NERD (5%) was higher than that of men having NERD (3%).…”

Section: Endoscopy-based Studymentioning

confidence: 80%

Section: Endoscopy-based Studymentioning

confidence: 99%

Section: Endoscopy-based Studymentioning

confidence: 99%

See 2 more Smart Citations

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

Self Cite

125

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show abstract

“…GERD can cause esophageal mucosal damage that may lead to esophageal bleeding or stricture, and can provoke long-term complications including Barrett's esophagus or esophageal adenocarcinoma (2,3). GERD often requires costly treatments, and prevalence has increased worldwide over recent decades (4)(5)(6)(7)(8). Considering the clinical impact of GERD, investigation of GERD risk factors in an asymptomatic general population may provide insight into how to prevent or treat this affliction.…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Study on the Risk Factors for Erosive Esophagitis in Young Adults

et al. 2012

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Objective To investigate the impact of metabolic and lifestyle factors on erosive esophagitis in young adults. Methods A total of 5,069 people under the age of 40 years old were enrolled in a medical survey at our institute. People with a previous history of upper gastrointestinal tract surgery were excluded, as were individuals taking medication for reflux symptoms, peptic ulcers, or malignancies. Independent and significant predictors affecting the presence of erosive esophagitis were determined by multivariate analysis. Results A total of 4,990 participants (male/female; 3,871/1,119, age; 33.9±3.9 years) were eligible. A total of 728 participants (14.6%) had erosive esophagitis. Male gender and increasing age were independent predictors for increased prevalence of erosive esophagitis (odds ratio=2.242 and 1.045. 95% confidence interval= 1.613-3.117 and 1.019-1.072; p<0.001 and 0.001, respectively). Moderate-to-heavy alcohol consumption, light-to-moderate-to-heavy smoking, hypertension, hyperglycemia, and hiatal hernia each significantly and independently increased the risk for erosive esophagitis (odds ratio=1.499, 1.398, 1.353, 1.570, 1.884, 1.297, 1.562, and 3.213. 95% confidence interval=1.181-1.903, 1.040-1.880, 1.094-1.675, 1.250-1.971, 1.307-2.716, 1.074-1.566, 1.063-2.295, and 2.712-3.807; p=0.001, 0.027, 0.005, <0.001, 0.001, <0.001, 0.007, 0.023, and <0.001 respectively). Helicobacter pylori infection decreased the risk for erosive esophagitis (odds ratio= 0.575, 95% confidence interval =0.436-0.759 p<0.001). Neither body mass index nor waist girth conferred increased risk of erosive esophagitis after adjusting for potential confounding factors. Conclusion Risk of erosive esophagitis in Japanese young adults was not increased by obesity, but it was increased by hiatal hernia and metabolic and lifestyle profiles including hypertension, hyperglycemia, alcohol consumption and smoking.

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Exploration of esophageal hypervigilance and anxiety status in patients with symptomatic gastroesophageal reflux disease: A single‐center study in Taiwan

Wong

Liang

Hung

et al. 2023

Adv in Digestive Medicine

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The esophageal hypervigilance and anxiety scale (EHAS) is a valuable cognitive‐affective evaluation of visceral sensitivity, which has been demonstrated to associate with gastroesophageal reflux disease (GERD) symptom severity and psychological stress. We aimed to obtain the values for EHAS in the setting of patients who underwent esophagogastroduodenoscopy (EGD) without GERD symptoms and investigate potential clinical factors contributing level of EHAS in symptomatic patients. Patients scheduled EGD with or without GERD symptoms were prospectively enrolled for assessing patient‐reported outcomes, including EHAS and GERD questionnaire (GERDQ). Patients without GERD symptoms had GERDQ ≤8 were classified as controls. Potential factors influencing the level of EHAS were identified via generalized linear model. We enrolled 534 patients, aged 20 to 84 years (mean, 52.78), of whom 54.2% were female; 110 had GERD symptoms, and 418 were controls. Patients with GERD symptoms had higher EHAS levels than controls (28.7 vs 10.2, P < .001). On generalized linear model GERDQ scores and female gender positively correlated with EHAS (GERDQ, β = 2.254, P < .001; female, β = 3.828, P = .001). In summary, our study suggests that greater esophageal hypervigilance and anxiety are associated with reflux symptoms burden across the spectrum of GERD, and correlate with female gender too.

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Clinical Spectrum of Reflux Esophagitis Among 25,536 Koreans Who Underwent a Health Check-up

Abstract: The prevalence of RE was found to be 7.91% in Korea, and the profiles of reflux symptoms were found to depend on grade of RE and sex.

Cited by 34 publications

References 55 publications

Sex and Gender Differences in Gastroesophageal Reflux Disease

Sex and Gender Differences in Gastroesophageal Reflux Disease

A Cross-Sectional Study on the Risk Factors for Erosive Esophagitis in Young Adults

Exploration of esophageal hypervigilance and anxiety status in patients with symptomatic gastroesophageal reflux disease: A single‐center study in Taiwan

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