Clinical Characteristics Of Patients With Mild Erosive Esophagitis

Objective:The Lyon Consensus identifies severe erosive esophagitis(EE)as the definitive basis for gastroesophageal reflux disease(GERD),whereas mild EE is more common in clinical practice.We aimed to analyze the risk factors for mild EE and evaluate the need for acid suppressants to provide a basis for treatment ideas in the mild EE population.Methods:Two hundred and thirty-seven patients diagnosed with EE from January2022 to June 2022 in the Department of Gastroenterology of the People’s Hospital of Hebei Province were selected,including 178 patients with mild EE.After following the inclusion and exclusion criteria,144 patients with mild EE were finally included(80 cases of grade A and 64 cases of grade B);mild EE was classified into symptomatic erosive esophagitis(SEE)and asymptomatic erosive EE(AEE)according to whether they were accompanied by clinical symptoms or not.AEE was classified as symptomatic erosive EE(SEE)and asymptomatic erosive EE(AEE).Forty-nine cases of grade A symptomatic erosive esophagitis(A-SEE),41 cases of grade B symptomatic erosive esophagitis(B-SEE),54 cases of AEE and 25cases of non-erosive reflux disease(N-erosive reflux disease,NERD)patients,questionnaires were administered,including general information,Gerd Q,Psychosomatic Disorders Scale score,Pittsburgh Sleep Quality Index Scale score and PPI treatment effect.Statistical methods such as ANOVA,chi-square test and LSD test were applied to analyze the data.Results:1.237 patients with EE,178 patients with mild EE,accounting for75.1%.2.Overall data analysis of patients with mild EE and NERD:male/female ratio 103/66;mean age(52.0±13.4)years;mean BMI range(25.1±4.0)kg/m~2;smoking 54 cases(32.0%);alcohol consumption 74 cases(43.8%);Gerd Q≥8 points 62 cases(36.7%);combined sleep disorders 63cases(37.3%);anxiety state 75 cases(44.4%);depressive state 56 cases(33.1%);115 cases treated with PPI and 69 cases positive for PPI(60.0%).3.Comparison of general information,risk factors and clinical symptom scales among the three groups of endoscopy-positive A-SEE,B-SEE and AEE patients:The difference in the positive diagnostic rate of Gerd Q scale among the three groups was statistically significant(χ~2=16.096,P<0.001),and the positive diagnostic rate of Gerd Q scale was significantly higher in the A-SEE and B-SEE groups than in the AEE group.There was no statistically significant difference in age,mean BMI,gender,smoking,alcohol consumption,sleep disorders,anxiety status,and depression status composition ratio between the three groups(P>0.05).4.Comparison of general information,predisposing factors and clinical symptom scales among the three groups of A-SEE,B-SEE and NERD patients with reflux symptoms:the difference was statistically significant when comparing the mean age among the three groups(F=3.722,P=0.024),and the mean age of patients in the A-SEE and B-SEE groups was lower than that in the NERD group;the difference was statistically significant when comparing the percentage of alcohol consumption The difference in the percentage of alcohol consumption was statistically significant(χ~2=6.678,P=0.035),and the percentage of alcohol consumption was higher in the A-SEE and B-SEE groups than in the NERD group;the difference in the positive diagnosis rate of Gerd Q scale was statistically significant(χ~2=8.263,P=0.016),and the positive diagnosis rate of Gerd Q scale was higher in the A-SEE and B-SEE groups than in the NERD group;the combined sleep disorder was statistically significant(χ~2=8.263,P=0.016).The difference was statistically significant(χ~2=10.245,P=0.006),and the combined sleep disorders of patients in the A-SEE and B-SEE groups were lower than those in the NERD group.The differences were not statistically significant(P>0.05)when comparing the mean BMI,gender,smoking,anxiety status,and depression status composition ratios among the three groups.5.Comparison of general information and rating scales among the three groups of patients with different subtypes of GERD,SEE,AEE and NERD:the difference was statistically significant when comparing the mean age among the three groups(F=3.882,P=0.020),the mean age of patients in the SEE group was lower than that in the NERD group;the difference was statistically significant when comparing the percentage of alcohol consumption(χ~2=6.837,P=0.033),the mean age of patients in the SEE and AEE groups was lower than that in the NERD group.The difference was statistically significant when comparing the positive diagnosis rate of Gerd Q scale(χ~2=20.023,P<0.001),and the positive diagnosis rate of Gerd Q scale was significantly higher in the SEE group than in the AEE and NERD groups;the difference was statistically significant when comparing the combined sleep disorders(χ~2=12.042,P=0.002),and the combined sleep disorders of patients in the SEE and AEE groups were lower than those in the NERD group.The differences were not statistically significant when comparing the mean BMI,gender,smoking,anxiety status,and depression status composition ratios among the three groups(P>0.05).6.Comparison of PPI treatment effect between SEE group and NERD group:the difference between the two groups was statistically significant(χ~2=42.347,P<0.001),and the PPI treatment effect of patients in the SEE group was significantly better than that in the NERD group.Conclusion:1.The majority of EE patients had mild EE(75.1%),SEE accounted for62.5%,and AEE accounted for 37.5%.2.Alcohol consumption was a predisposing factor in EE patients.Advanced age and sleep disorders were associated with the occurrence of NERD.3.The Gerd Q scale has a higher positive diagnostic rate for SEE patients compared to AEE and NERD patients.4.21.5%of the patients without PPI use were grade A and 13.9%were grade B.Symptom improvement in the short term was significantly better in patients with mild EE treated with PPI than in patients with NERD.