Esophagitis in a High H. pylori Prevalence Area: Severe Disease Is Rare but Concomitant Peptic Ulcer Is Frequent

Abstract

BackgroundFew data are available on the prevalence of erosive and severe esophagitis in Western countries.ObjectiveTo retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain.DesignRetrospective observational study. A multivariate analysis was performed to determine variables predicting severe esophagitis.SettingDatabases of 29 Spanish endoscopy units.PatientsPatients submitted to a diagnostic endoscopy during the year 2005.InterventionsRetrospective review of the databases.Main Outcome MeasurementsEsophagitis severity (graded according to the Los Angeles classification) and associated endoscopic findings.ResultsEsophagitis was observed in 8.7% of the 93,699 endoscopies reviewed. Severe esophagitis (LA grade C or D) accounted for 22.5% of cases of the disease and was found in 1.9% of all endoscopies. Incidences of esophagitis and those of severe esophagitis were 86.2 and 18.7 cases per 100,000 inhabitants per year respectively. Male sex (OR 1.89) and advanced age (OR 4.2 for patients in the fourth age quartile) were the only variables associated with severe esophagitis. Associated peptic ulcer was present in 8.8% of cases.LimitationsRetrospective study, no data on individual proton pump inhibitors use.ConclusionsSevere esophagitis is an infrequent finding in Spain. It occurs predominantly in males and in older individuals. Peptic ulcer disease is frequently associated with erosive esophagitis.

Prevalence of severe esophagitis in Spain. Results of the PRESS study (Prevalence and Risk factors for Esophagitis in Spain: A cross‐sectional study)

“…Furthermore, many factors that might influence the development of these diseases – for example, the type of predominant diet, tobacco or alcohol consumption, or proton pump inhibitor (PPI) use – have been steadily changing in recent years. A previous retrospective study by our group found the prevalence of esophagitis to be low, appearing in only 8.7% of 93,699 endoscopies reviewed 9 …”

“…A previous retrospective study by our group found the prevalence of esophagitis to be low, appearing in only 8.7% of 93,699 endoscopies reviewed. 9…”

“…A previous retrospective study by our group found the prevalence of esophagitis to be low, appearing in only 8.7% of 93,699 endoscopies reviewed. 9 In addition, at present, it is not fully understood which additional risk factors contribute to the development of reflux esophagitis or what influence these factors might have on disease severity. Possible risk factors reported include overweight, male gender, history of GERD, smoking habit, absence of Helicobacter pylori or presence of hiatal hernia.…”