Comparison Of Clinical Features Between Asymptomatic Erosive Esophagitis And Symptomatic Erosive Esophagitis

Background:Gastroesophageal reflux disease(GERD)is a common disease,and currently we have discovered more and more patients of GERD without symptoms,including typical and atypical symptoms.The disease is defined as asymptomatic erosive/reflux esophagitis.The research on these diseases is not much at home and abroad.The epidemiology,clinical features,risk factors,pathogenesis,diagnosis,treatment and prognosis of asymptomatic erosive esophagitis are still not well understood,which has aroused my concern.Purpose:This study was performed to investigate the prevalence of AEE and clinical features associated with symptom presentation among patients with EE in Eastern China.Methods:A total of 3,052 subjects who underwent medical checkups from January 2012 to December 2015 in the health promotion center of our hospital were retrospectively reviewed.326 patients with erosive esophagitis(EE)who met diagnostic and evaluation criteria were enrolled.Information of reflux diagnostic questionnaires(RDQ),demographical characteristics,endoscopic findings,reflux-related symptoms,presence of metabolic syndrome,and biochemical parameters of patients with EE were collected.One factor and multiple logistic regression analysis were used to compare the differences between patients with AEE and symptomatic EE(SEE).Results:Of 3,052 subjects eligible for this study,326 subjects were found to have EE.The prevalence of AEE and SEE in all check-up subjects was 4.9%(151/326)and 5.7%(175/326),respectively.No difference of age(AEE=47.78±12.16 vs.SEE= 48.02±11.84,P>0.05),gender(Male)(AEE=72.2%vs.SEE= 78.3%,P>0.05),hiatal hernia(AEE=9.3%vs.SEE=12%,P>0.05),H.pylori(AEE=24.5%vs.SEE=22.3%,P>0.05),blood pressure(AEE=125.36±15.48/77.13±10.36 vs.SEE=123.10±16.64/77.10±10.62,P>0.05),fasting glucose(AEE=5.39±1.38 vs.SEE=5.63±1.34,P>0.05),TG(AEE=1.66±1.51 vs.SEE=1.77± 1.50,P>0.05),or HDL-C(AEE=1.27±0.38 vs.SEE=1.21±0.33,P>0.05)metabolic syndrome(AEE=24.5%vs.SEE=29.1%,P>0.05)were found between AEE and SEE.In addition,these 2 groups had no significant difference regarding Los Angels types(AEE=LA-A 80.1%/LA-B 18.5%/LA-C 1.3%vs.SEE=LA-A 74.3%/LA-B 23.4%/LA-C 2.3%,P>0.05).The SEE group had more smokers(SEE=45.7%vs.AEE=31.8%,P<0.05)and dingkers(SEE=41.7%vs.AEE=27.8%,P<0.05)than the AEE group.Most erosive esophagitis cases were mild endoscopic esophagitis of Los Angeles grade A or B.In multivariate analysis,BMI(AOR=1.11,95%CI:1.00-1.23,P=0.044),smoking(AOR=1.67,95%CI:1.05-2.65,P=0.03),and alcohol drinking(AOR=1.69,95%CI:1.05-2.72,P=0.030)were found to be independent risks factors to developing gastroesophageal reflux symptoms in patients with EE.Conclusions:AEE is common in Chinese population,and its prevalence is similar to that of SEE.Higher BMI,smoking,and alcohol drinking were risk factors associated with symptom presentation in patients with EE.