Risk factors of reflux esophagitis observed in tertiary care centre of Nepal

Abstract

Introduction: Gastroesophageal reflux disease (GERD) is considered to be common disease in western countries. The prevalence of GERD is believed to be less in Asia than in Western countries. Upper GI Endoscopy is the valuable tools in the evaluation of reflux esophagitis which is a common complication of GERD. The present study aimed to determine the risk factor of Reflux Esophagitis in Nepalese with Gastroesophageal Reflux disease symptoms.

Methods: It was a cross sectional observational study conducted in the department of Gastroenterology at Tribhuvan University, Institute of Medicine. Patients were recruited as per inclusion and exclusion criteria. The study involved data on 166 patients with Gastroesophageal reflux disease symptoms. After fulfilling the criteria of validated GERD questionnaire, patient were divided into two groups those having reflux esophagitis and Non erosive reflux disease according to the upper Gastrointestinal Endoscopy. Association of reflux esophagitis with different variables including patient characteristics, clinical features of GERD and endoscopic findings were tested using Chi-square test for discrete variables and continuous variables are measured as Mean SD. Multivariate analysis was performed for the association of risk factors with reflux esophagitis using logistic regression analysis. p value <0.05 was considered statistically significant.

Results: Among the total of 166 patients with GERD, 63.3% were female and 36.7% were male. Mean BMI of the patient was 23.47±4.59. Of the total 7.8% had history of smoking and 12% patients were alcohol consumer. 27.7% patients were found to have reflux esophagitis. There was statistically significant difference between gender of the patients between the two group (p value=0.05). There was significant association found between current smoking and reflux esophagitis (p=0.03), also, between alcohol consumer and reflux esophagitis (p=0.021) While comparing the endoscopic findings Hiatus hernia was found significantly associated with Reflux esophagitis (p=0.004), Mean BMI and presence of peptic ulcer disease was not significantly associated with Reflux esophagitis (p=0.9) and (p=0.36).

Conclusion: The frequency of Reflux esophagitis is 27.7% in our Nepalese patient. Reflux esophagitis is more common in male, predominantly in current smoker and alcoholics and those who are having hiatus hernia. Abstinence of smoking and alcohol drinking along with lifestyle modification might be important steps for prevention of Reflux esophagitis.