The Clinical Features and Predisposing Factors of Asymptomatic Erosive Esophagitis

• Published in: Digestive diseases and sciences Vol. 61; no. 12; pp. 3522 - 3529
• Main Authors: Lee, Sang Pyo, Sung, In-Kyung, Kim, Jeong Hwan, Lee, Sun-Young, Park, Hyung Seok, Shim, Chan Sup
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2016; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol Drinking - epidemiology; Antibodies, Bacterial - immunology; Asymptomatic Diseases - epidemiology; Biochemistry; Body Mass Index; Endoscopy; Endoscopy, Digestive System; Esophagitis; Esophagitis, Peptic - epidemiology; Female; Gastroenterology; Gastroesophageal Reflux - epidemiology; Health aspects; Helicobacter infections; Helicobacter Infections - epidemiology; Helicobacter Infections - immunology; Helicobacter pylori; Helicobacter pylori - immunology; Hepatology; Hernia; Hernia, Hiatal - epidemiology; Humans; Immunoglobulin G; Immunoglobulin G - immunology; KCT; KCT0001716; Male; Medical colleges; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Pneumoviridae; Prevalence; Republic of Korea - epidemiology; Risk Factors; Sex Factors; Smoking - epidemiology; Surveys and Questionnaires; Transplant Surgery; Young Adult; Erosive esophagitis; Esophagitis; Gastroesophageal reflux disease; Reflux esophagitis; Smoking
• DOI: 10.1007/s10620-016-4341-9
• ISSN: 0163-2116; 1573-2568

Background Asymptomatic erosive esophagitis (AEE) is considered an erosive esophagitis without the typical reflux symptoms, but the clinical course and significance of AEE is still unclear. Aim We investigated the prevalence and predisposing factors of AEE, and tried to determine its clinical features and significance. Methods Subjects, who had at least two health inspections (upper endoscopy, self-reporting questionnaire, and serum Helicobacter pylori IgG antibody test) at our center, were enrolled. The questionnaire included typical reflux symptoms, previous medical history, underlying disease, smoking, alcohol intake, and medication history. Based on the results of follow-up study, the changes in endoscopic findings and reflux symptoms were also investigated. Results Of the 2961 patients visiting our clinic, 568 (19.2 %) were diagnosed with AEE. Age over 50 years, male sex, a body mass index over 25, current smoking, heavy drinking, negativity for H. pylori infection, and hiatal hernia were independent predisposing factors for AEE ( p  = 0.020, p  < 0.001, p  < 0.001, p  = 0.013, p  = 0.003, p  < 0.001, p  = 0.038, respectively). Within the follow-up period (mean 25 ± 9.5 months), reflux symptoms developed in 30 subjects (7.9 %), and current smoking was the only risk factor for the development of AEE symptoms ( p  = 0.015). On the follow-up endoscopy, erosive esophagitis disappeared in nearly half of the subjects with AEE (174, 45.6 %). Conclusions AEE is common, but many cases of AEE may be spontaneously cured without treatment. Although symptom development is rare, quitting smoking may be helpful as a prevention strategy. Clinical Trial Registration Number KCT0001716.