The prevalence of endoscopic esophagitis in duodenal ulcer patients and symptomatic controls

A large series of duodenal ulcer patients was examined in order to determine the prevalence rate of reflux esophagitis and compare it to that of a series of symptomatic controls, as well as to find out if complicated duodenal ulcer patients are at a higher risk of developing reflux esophagitis.

All consecutive patients attending the Endoscopy unit between January and December 1996 who were found to have duodenal ulcers were prospectively recruited for this study. Consecutive patients with upper abdominal symptoms but negative gastroscopy for duodenal ulcers were used as a control. Patients known to have reflux esophagitis, those on peptic ulcer treatment for more than a week, those with dysphagia as a presenting symptom or underlying upper gastrointestinal malignancy, and patients who had undergone previous ulcer surgery were excluded from the study. A hundred and forty-one patients were found to have duodenal ulcer (Group I), and one hundred and seventy-two served as a control (Group II). The two groups were matched for age, NSAID ingestion and smoking habit. However, Group I included significantly more patients with underlying co-morbid conditions and fewer females.

The prevalence of reflux esophagitis was similar between both groups, 30.5% vs. 38.4%, P=0.18. Furthermore, bleeding duodenal ulcer patients (sub-group III) were compared to non-bleeding duodenal ulcer patients (sub-group IV). Although Group III included significantly more smokers, NSAID ingestion and comorbid conditions, there was no significant difference in the prevalence rate of reflux esophagitis, P=0.13. Moreover, 92.7% of afflicted patients suffer mild or moderate esophagitis.

Endoscopic esophagitis is a frequent finding in both duodenal ulcer and control subjects.