Endoscopic Reflux Esophagitis and Helicobacter pylori Infection in Young Healthy Japanese Volunteers

Takashima, Tadayoshi; Iwakiri, Ryuichi; Sakata, Yasuhisa; Yamaguchi, Daisuke; Tsuruoka, Nanae; Akutagawa, Kayo; Komatsu-Tanaka, Miho; Higuchi, Toru; Tanaka, Yuichiro; Shimoda, Ryo; Sakata, Hiroyuki; Kawakubo, Megumi; Oda, Yoshimasa; Fujimoto, Kazuma

doi:10.1159/000338849

Cited by 36 publications

(29 citation statements)

References 79 publications

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“…The Lyon Consensus regarded LA grade A&B EE as the inconclusive evidence for GERD diagnosis for the reason that LA grade A&B EE can be encountered in 5.0%‐7.5% of asymptomatic controls, and only 1%‐6% of LA grade A&B EE could progress to LA grade C&D EE . A previous study performed among 2580 individuals referred for upper endoscopy in our hospital found that the detection rate of EE was only 4.30%, which was much lower than that of 11.8%‐15.5% in western countries .…”

Section: Discussionmentioning

confidence: 88%

Esophageal physiologic profiles within erosive esophagitis in China: Predominantly low‐grade esophagitis with low reflux burden

Zhang

Tan

et al. 2019

Neurogastroenterology Motil

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Background & aims The Lyon Consensus defines LA grades C&D erosive esophagitis (EE) or acid exposure time (AET) >6% as the conclusive evidence for gastro‐esophageal reflux disease (GERD). However, most of EE is LA grade A&B and the rate of AET exceeding 6% is low in China. We aimed to evaluate patients with EE in the Chinese population based on the Lyon Criteria. Methods A retrospective study was performed among patients with EE who had esophageal function tests performed in a tertiary hospital from 2013 to 2017. Erosive esophagitis was staged according to the Los Angeles classification. Their motor profiles from high‐resolution manometry (HRM), reflux profiles from multichannel intraluminal impedance‐pH (MII‐pH) monitoring and proton pump inhibitor (PPI) efficacy were analyzed. Patients were categorized as conclusive or inconclusive GERD. Results Among 112 patients with EE who underwent esophageal function tests, EE of LA grade C&D was found in only 4.46% (N = 5). Almost 35% (N = 37) of patients with LA grade A&B EE had AET exceeded 6%, who had good PPI response similar to those with LA grade C&D EE (77.42% vs 100%, P = .559). The remaining 70 patients (62.50%) were inconclusive GERD, of whom 56.25% responded to PPI. Inconclusive GERD patients had a wide range (7.14%‐97.14%) of positive adjunctive evidences from HRM and MII‐pH monitoring without significant correlation to PPI response rate. Conclusions The reflux burden within patients with EE is predominantly low in China, and adjunctive HRM and MII‐pH profiles from Lyon criteria do not segregate PPI response.

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Section: Discussionmentioning

confidence: 88%

Esophageal physiologic profiles within erosive esophagitis in China: Predominantly low‐grade esophagitis with low reflux burden

Zhang

Tan

et al. 2019

Neurogastroenterology Motil

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“…(7–9) Due to improved sanitation and the reduced chance of infection during childhood, H. pylori infection is rapidly decreasing in Japan, (10–13) along with peptic ulcer diseases and gastric cancers. However, this decreased rate of H. pylori infection has led to increases in cases of gastric acid secretion and gastroesophageal reflux diseases.…”

Section: Discussionmentioning

confidence: 99%

“…(7–9) In Japan, the rate of H. pylori infection has steadily decreased, partly due to improved sanitation. (10–13) …”

Section: Introductionmentioning

confidence: 99%

Case-control study of association of eosinophilic gastrointestinal disorders with Helicobacter pylori infection in Japan

Furuta

Adachi

Aimi

et al. 2013

J. Clin. Biochem. Nutr.

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Recent studies have suggested that decrease in Helicobacter pylori infection may predispose to allergic diseases. However, there are few reports of the relationships of eosinophilic gastrointestinal disorders (EGIDs), especially eosinophilic gastroenteritis (EGE), with H. pylori infection. We investigated the possible influence of H. pylori infection on EGIDs in Japanese patients. We performed a case-control study to investigate the prevalence of H. pylori infection in patients with EGIDs. Eighteen with eosinophilic esophagitis (EoE) and 22 with EGE were enrolled. For each patient, 3 age- and gender-matched normal controls (n = 120) were randomly selected from a population who received a medical check-up between April 2010 and December 2011 at the Shimane Institute of Health Science. The mean ages of the EoE and EGE patients were 50.9 ± 17 and 49.2 ± 20 years, respectively. Males were more frequently seen in the EoE group, while there was no significant gender difference in regard to EGE. Of the patients with EoE, 22.3% were infected with H. pylori, as compared to 55.5% of their age- and sex-matched normal controls. The odds ratio for EoE patients to have an H. pylori infection was 0.22 (p<0.05). In addition, 22.7% of the patients with EGE and 48.5% of their matched controls were infected with H. pylori, with odds ratio for EGE patients to have an H. pylori infection shown to be 0.31 (p<0.05). In conclusion, the prevalence of H. pylori infection was significantly lower in EGE and EoE patients in Japan as compared to normal control subjects.

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“…Low‐grade esophagitis (grade A or B) was no longer considered as a confirmatory evidence of gastroesophageal reflux disease (GERD) in Lyon consensus . It is because some studies showed that low‐grade esophagitis is non‐specific for GERD and could be found in 5%‐7.5% of asymptomatic controls . To our knowledge, the prevalence of the pathological acid reflux in Chinese patients with low‐grade esophagitis was not known.…”

Section: Introductionmentioning

confidence: 99%

The importance of pH reflux monitoring test for the management of low‐grade esophagitis in Chinese patients

Qiu

Zhang

Bai

et al. 2019

Neurogastroenterology Motil

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Background and aims Low‐grade esophagitis (grade A and B) are no longer believed as confirmatory evidence of gastroesophageal reflux disease, but there were no data about the association of low‐grade esophagitis with pathological acid reflux (PAR) in China. This study aimed to summarize the proportion of PAR in the patients with low‐grade esophagitis and to explore the differential factors between low‐grade esophagitis patients with and without PAR. Methods Database of the patients accepted 24‐hour pH monitoring in the motility laboratory of a tertiary center was retrospectively searched, and the patients were diagnosed as low‐grade esophagitis before the procedure was recruited. The demographics, symptoms and high‐resolution manometry and pH monitoring parameters were compared between the patients with pathological and physiological acid reflux and between patients with grade A and B esophagitis. Results About 24% of grade A and 55% of grade B esophagitis patients had pathological acid reflux. The demographics, symptoms, and almost all high‐resolution manometry findings were similar in patients with pathological and physiological acid reflux. About two‐thirds of the participants with physiological acid reflux reported symptom improvement after PPI administration. All participants with PPI‐resistant symptoms were with physiological acid reflux. Conclusion The proportion of PAR in low‐grade esophagitis is not high. For patients with low‐grade esophagitis in China, especially the patients with grade A esophagitis, regardless of symptom change, reflux monitoring is possibly needed for the patients whose esophageal mucosa break is not improved after 8 weeks of PPI treatment.

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Endoscopic Reflux Esophagitis and Helicobacter pylori Infection in Young Healthy Japanese Volunteers

Cited by 36 publications

References 79 publications

Esophageal physiologic profiles within erosive esophagitis in China: Predominantly low‐grade esophagitis with low reflux burden

Esophageal physiologic profiles within erosive esophagitis in China: Predominantly low‐grade esophagitis with low reflux burden

Case-control study of association of eosinophilic gastrointestinal disorders with Helicobacter pylori infection in Japan

The importance of pH reflux monitoring test for the management of low‐grade esophagitis in Chinese patients

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