Document Detail


Multivariate analysis of the association of acid and duodeno-gastro-oesophageal reflux exposure with the presence of oesophagitis, the severity of oesophagitis and Barrett's oesophagus.
MedLine Citation:
PMID:  18403496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exposure to acid and duodeno-gastro-oesophageal reflux (DGOR) both increase with oesophageal lesions in gastro-oesophageal reflux disease (GORD). It is unknown whether DGOR exposure is an independent risk factor for oesophageal lesions. A multivariate analysis was performed on the relationship between oesophageal lesions and demographics and acid and DGOR exposure. METHODS: In 422 patients with suspected GORD, upper endoscopy, oesophageal manometry, and pH and DGOR monitoring were performed. Stepwise logistic regression was used to identify factors associated with the presence of oesophagitis, severity of oesophagitis and the presence of Barrett's oesophagus. ORs and 95% CIs were computed at different cut-offs. RESULTS: 54% of the patients had no oesophagitis, 36% had grade A-B oesophagitis, 3% had grade C-D oesophagitis and 7% had Barrett's oesophagus. In multivariate analysis, oesophagitis was associated with hiatal hernia (OR 3.621, 95% CI 2.263 to 5.794) and DGOR exposure (OR up to 2.236, 95% CI 1.356-3.685), while a low body mass index (BMI) seemed protective (OR for BMI >first quartile 2.245, 95% CI 1.371 to 3.677). Severity of oesophagitis was only associated with acid exposure (OR up to 5.038, 95% CI 1.452 to 17.480). The presence of Barrett's oesophagus was associated with male sex (OR 3.621, 95% CI 2.263 to 5.794), DGOR (OR up to 5.017, 95% CI 2.051 to 12.274) and acid exposure (OR up to 3.031, 95% CI 1.216 to 7.556). CONCLUSIONS: Several independent factors are associated with oesophageal lesions in GORD. The risk of oesophagitis is associated with hiatal hernia, BMI and DGOR exposure; severity of oesophagitis depends on acid exposure; and Barrett's oesophagus is associated with male sex and exposure to both acid and DGOR.
Authors:
G H Koek; D Sifrim; T Lerut; J Janssens; J Tack
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Publication Detail:
Type:  Journal Article     Date:  2008-04-10
Journal Detail:
Title:  Gut     Volume:  57     ISSN:  1468-3288     ISO Abbreviation:  Gut     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-16     Completed Date:  2008-08-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1056-64     Citation Subset:  AIM; IM    
Affiliation:
Center for Gastroenterological Research, University Hospital Gasthuisberg, Leuven, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adult
Barrett Esophagus / etiology*
Body Mass Index
Esophagitis, Peptic / etiology*
Esophagoscopy
Female
Gastroesophageal Reflux / complications*
Hernia, Hiatal / complications
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Monitoring, Ambulatory / methods
Multivariate Analysis
Risk Factors
Severity of Illness Index
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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