CLINICAL AND ENDOSCOPIC EVALUATION IN PATIENTS WITH GASTROESOPHAGEAL SYMPTOMS

The gastroesophageal reflux disease (GERD) is the most common esophageal disease in medical practice, and it is suspected according to patients' symptoms. GERD can be classified in erosive esophagitis (EE) according to the presence of upper gastrointestinal endoscopy findings.

To evaluate endoscopic findings in patients with symptoms suggestive of GERD comparing epicemiological and risk factors.

Upper endoscopy reports were examined retrospectively from patients with symptoms of GERD such as heartburn, regurgitation, cough, throat clearing, globus and chest pain. EE was determined based on Los Angeles classification. Comparisons between risk factors in EE and non-EE groups were done with statistical analysis.

A total of 984 endoscopic reports were examined and 676 selected for analysis (281 with EE and 395 with non-EE form). Most were female 381 (56.36%) with a mean age of 44.01±15.40 years. Hiatal hernia was present in 47(6.96%) and smoking in 41(6.07%). Univariate logistic regression showed that male (OR=2.24, CI 95%, 1.63-3.06) and hiatal hernia (OR=4.52, CI 95%, 2.30-8.89) were independent predictors of erosions in the EE group. The presence of hiatal hernia (OR=12.04, CI 95%, 3.57-40.62), smoking (OR=8.46, CI 95%, 3.28-31.32) and aged patients (OR=8.01, CI 95%, 2.42-26.49) were also indicated as a risk factor for severe EE (grades C and D of Los Angeles).

Male gender and hiatal hernia were associated with EE. Aged patients, smoking and hiatal hernia were related to severe EE. It is suggested that the risk factors for EE and non-EE types are different. Cohort studies are necessary to identify the exact mechanisms involved in each disease form.