The Prevalence And Clinical Features Of Gastroesophageal Refulx Disease And Its Subtypes

AIM: To investigate the prevalence of gastroesophageal reflux disease(GERD), andanalyze the related risk factors, and understand the clinical characteristics of GERDsubtypes.METHODS: A validated questionnaire investigation about GERD symptoms and itsrelated factors was carried out in outpatients who first visited Department ofDigestion in Fuzhou General Hospital,Nanjing Military Region of PLA, from July2012to October2012. According to RDQ Score definition, patients with score morethan11(Sc≥12) were taken in GERD group, including patients with score less than12(Sc<12) but their symptoms relieved by PPI diagnostic treatment and patients withthe presence of esophageal damage (RE or BE) on endoscopy. The others were takenin non-GERD group. Then, the GERD patient group was divided into three groups,including non-erosive reflux disease(NERD), reflux esophagitis(RE) and Barrett’sesophagus(BE), for further analysis.RESULTS: A total of991patients were investigated. The prevalence of GERD inoutpatients who first visited Department of Digestion in Fuzhou GeneralHospital,Nanjing Military Region of PLA, was23.41%, and male to female ratio was1:1.25. In the GERD group, There were134cases(57.76%) in NERD，36cases(15.52%) in RE， and62cases(26.72%) in BE. The peak age of GERD was41~60years old (P＜0.05). NERD mainly distributed in31~50years old, RE in41~50years old, and BE in41~60years old, but there was no significantly correlationamong them. Besides, fat patients whose body mass index were more than28kg/m2(BMI≥28kg/m2) prone to GERD. Heartburn and reflux were the cardinal symptomsof GERD, but31cases in GERD were found completely without typical GERDsymptoms, including25cases in BE,5cases in RE, and1case in NERD. Most ofNERD(70.15%) had typical and serious GERD symptoms, in which the prevalence ofheartburn was highest(70.40%) when they visited hospital. And RE patients had mild symptoms, with the cardinal symptom of heartburn(33.87%). Most of BE(79.03%)were found with RDQ scores less than12, with the cardinal symptom of acidregurgitation (33.87%). In RE patients, there were27cases in grade A,7cases ingrade B,1case in grade C, and1case in grade D.94.44％of RE patients were in lowgrade(grade A and grade B). Besides, there was a significantly positive correlationbetween endoscopy grading of RE and symptoms scores according to RDQ Scoredefinition. Meanwhile,4cases RE were complicated with BE. In BE patients, Islandwas the most one in the types of BE and the circumference was the least one. Besides,most of BE was SSBE(98.39％). Patients in GERD group had higher incidence of thesymptoms of throat discomfort, chronic cough and mouth ulcer and so on(P＜0.05).Besides, BMI, smoke, coffee, eating greasy, sweetmeat and overeating werefound to be correlated with GERD by univariate analysis(P<0.05)，and multivariateconditional logistic regression analysis demonstrated that smoke(OR1.799,P=0.034),coffee(OR3.274,P=0.021), sweetmeat(OR2.534,P=0.001), and overeating (OR1.419,P=0,047) were the risk factors of GERD.CONCLUSIONS: The prevalence of GERD in outpatients of digestive systemdepartment is high. Most of GERD are NERD which has typical and serious GERDsymptoms. Most of BE are SSBE with mild symptoms or without symptoms. REpatients always have mild symptoms. The peak age of GERD is41~60years old.Obese patients prone to GERD. GERD is accompanied by more estraesophagealperformance at the same time, and multiple factors influence GERD symptoms.