Erosive Esophagitis in Asymptomatic Subjects: Risk Factors

Abstract

Efecto del bypass gástrico en la esofagitis erosiva en pacientes con obesidad mórbida Background: Obesity is an important risk for pathological gastroesophageal reflux. Aim: To assess the effects of gastric bypass on obese subjects with erosive esophagitis. Patients and methods: Sixty two morbid obese subjects (aged 16 to 70 years, 41 females) with erosive esophagitis at the moment of surgery were studied. These patients were subjected to a gastric bypass with gastric resection. They were followed with upper gastrointestinal endoscopy every one year, looking for the presence of erosions or ulcers in the distal esophagus. Results: The mean follow up period was 21 months. Prior to surgery all patients had heartburn or regurgitation and at two years after surgery, 97% were asymptomatic. Esophagitis was found in 97 and 6.5% before and after surgery, respectively. Two patients had an esophageal ulcer, that healed on follow up endoscopy. There was a 72% reduction of overweight on late follow up. Conclusions: Gastric bypass is effective to control pathological gastroesophageal reflux in patients with morbid obesity (Rev Méd Chile 2006; 134: 285-90). (

Determinants of symptoms in gastroesophageal reflux disease

“…This is consistent with previous studies; however, the pathogenesis of silent EE remains controversial [8,36,37]. Nguyen et al [38] reported that healthy male patients show relative esophageal hyposensitivity in response to balloon distention compared with healthy female patients, which might explain the sex difference in the symptom presentation of esophagitis.…”

Erosive Tooth Wear: A Multifactorial Condition of Growing Concern and Increasing Knowledge

“…When dealing with dental erosion, the main focus is strongly placed on the consumption of acidic soft drinks, whereas silent gastroesophageal reflux can be easily overseen. Different studies have shown that about 35% of patients who had not reported symptoms of gastroesophageal reflux, nor had treatment for it, presented actual pathological reflux when assessed with 24-hour oesophageal pH measurements [21][22][23][24]. This silent gastroesophageal reflux must also be taken into account when examining patients presenting erosive tooth wear.…”

Clinical characteristics and natural history of asymptomatic erosive esophagitis

“…Male sex, old age (>65 years old), hiatal hernia, smoking, alcohol, Caucasian race, and obesity are independent risk factors associated with asymptomatic esophagitis (8,(15)(16)(17). Atrophy, Helicobacter pylori infection, and peptic ulcer are not considered to be risk factors for provoking asymptomatic EE, while there are varying reports of association between BMI and asymptomatic EE (7,8,18).…”

“…Japanese patients with EE appear to be less likely to report clinical symptoms than Western patients (6). Smoking, body mass index (BMI), and gender are related to asymptomatic EE (7,8).…”