Ethnic differences in gastro-oesophageal reflux disease

To see whether the anecdotal statement that gastro-oesophageal reflux disease is less common in blacks than in white Caucasians is true.

Study of the racial origin of adult patients who, at endoscopy, have oesophageal damage due to gastro-oesophageal reflux.

Gastroenterology unit of a teaching hospital in inner city Birmingham, UK.

Ethnicity and endoscopic grade of oesophageal damage (reflux oesophagitis) were recorded in every patient in whom oesophageal damage due to gastro-oesophageal reflux was diagnosed.

Over the eight-year period 1989-1996, 1101 patients with endoscopically diagnosed grades I-V reflux oesophagitis have been seen, of whom 893 (81.9%) were white, 156 (14%) were Indian and 52 (5%) were Afro-Caribbeans. There were fewer patients with reflux oesophagitis from the two non-white ethnic groups than would be expected from their prevalence in the catchment population, and severe reflux oesophagitis was less common than expected in the two non-white groups. In all groups, patients with grades III, IV and V reflux oesophagitis were older than patients with grades I and II disease. Whites tended to be older than Afro-Caribbeans or Indians.

There were fewer non-whites with reflux oesophagitis than would be expected but the reasons for this are unclear. This study has been useful as a pilot but further studies are needed in ethnically mixed non-migrant populations both in hospital, primary care and the community to clarify racial differences in reflux oesophagitis.