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Abstract
Background/Aims
Recent studies suggest that the prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea. However, studies on risk factors for GERD have yielded inconsistent results. The aims of this study were to compare clinical features between symptomatic syndromes without esophageal injury (=non-erosive disease [NED]) and syndromes with esophageal injury (=erosive disease [ED]), and to determine risk factors associated ED.
Methods
A total of 450 subjects who visited gastroenterology clinics of six training hospitals in Daegu from March 2008 to April 2010 were consecutively enrolled. The subjects were asked to complete a questionnaire which inquired about gastroesophageal reflux symptoms. The questionnaire also included questions about smoking, alcohol drinking, consumption of coffee, use of drugs, exercise, and other medical history. The subjects were subdivided into NED and ED groups.
Results
The proportion of subjects in each NED and ED group was 172 (38.2%) and 278 (61.8%). Male gender, smoking, alcohol drinking, consumption of coffee, large waist circumference, infrequent medication of antacids, aspirin and NSAIDs, infrequent and mild GERD symptoms were all significantly associated with ED on univariate analysis. Age, hiatal hernia, diabetes mellitus, body mass index, change in weight during 1 year, and number of typical GERD symptoms were not independent risk factors for ED. However, the association between ED and alcohol drinking, infrequent medication of antacids, mild typical GERD symptoms remained as strong risk factors after adjustments on multivariate logistic analysis.
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Table 1.
Patient Characteristics (n=450)
Table 2.
Factors Associated with Erosive Disease
Table 3.
Symptoms Associated with Erosive Disease
| Variable | NED (%) | ED (%) | p-value |
|---|---|---|---|
| Number of typical GERS a | 0.953 | ||
| 1 | 74/172 (43.0) | 97/227 (42.7) | |
| 2 | 98/172 (57.0) | 130/227 (57.3) | |
| Frequency of typical GERS b | 0.002 | ||
| 1/week | 39/172 (22.7) | 55/163 (33.7) | |
| ≥2/week | 67/172 (39.0) | 70/163 (42.9) | |
| Daily | 66/172 (38.4) | 38/163 (23.3) | |
| Severity of typical GERS | 0.001 | ||
| Mild | 6/172 (3.5) | 25/228 (11.0) | |
| Moderate | 109/172 (63.4) | 153/228 (67.1) | |
| Severe | 57/172 (33.1) | 50/228 (21.9) | |
| Atypical symptoms | |||
| Globus sensation | 54/172 (31.4) | 56/278 (20.1) | 0.007 |
| Dysphagia | 72/170 (42.4) | 82/276 (29.7) | 0.006 |
| Belching | 95/172 (55.2) | 104/278 (37.4) | ＜0.001 |
| Coughing | 45/172 (26.2) | 78/278 (28.1) | 0.661 |
| Wheezing | 35/172 (20.3) | 65/276 (23.6) | 0.429 |
| Dyspnea on exertion | 36/172 (20.9) | 53/278 (19.1) | 0.629 |
| Hoarseness | 56/172 (32.6) | 80/278 (28.8) | 0.396 |
Table 4.
Risk Factors for Erosive Disease
| Risk factor | Inivariate analysis, R OR (95% CI) | Multivariate analysis, OR a (95% CI) |
|---|---|---|
| Male vs. female gender | 2.95 (1.98–4.38) | − |
| Alcohol users vs. non-users | 2.57 (1.75–3.78) | 1.83 (1.07–3.12) |
| Smokers vs. non-smokers | 2.36 (1.56–3.59) | − |
| Coffee users vs. non-users | 1.51 (1.02–2.24) | − |
| Antacids medication | 0.46 (0.32–0.68) | 0.61 (0.38–0.97) |
| Aspirin or NSAIDs medication | 0.50 (0.31–0.82) | − |
| Waist circumference (cm) | ||
| ＜80 vs. 80.0–89.9 | 1.76 (1.14–2.72) | − |
| ＜80 vs. 90.0–99.9 | 1.91 (1.11–3.30) | − |
| ＜80 vs. ≥100 | 3.65 (1.28–10.44) | − |
| Severity of typical GERS | ||
| Mild vs. Moderate | 0.34 (0.13–0.85) | − |
| Mild vs. Severe | 0.21 (0.08–0.56) | 0.27 (0.09–0.81) |
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