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.
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: R A Filiberti; V Fontana; A De Ceglie; S Blanchi; E Grossi; D Della Casa; T Lacchin; M De Matthaeis; O Ignomirelli; R Cappiello; A Rosa; M Foti; F Laterza; V D'Onofrio; G Iaquinto; M Conio Journal: Eur J Clin Nutr Date: 2017-05-10 Impact factor: 4.016
Authors: Julian A Abrams; Reem Z Sharaiha; Lou Gonsalves; Charles J Lightdale; Alfred I Neugut Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-12-02 Impact factor: 4.254
Authors: Zhan Su; Laura J Gay; Amy Strange; Claire Palles; Gavin Band; David C Whiteman; Francesco Lescai; Cordelia Langford; Manoj Nanji; Sarah Edkins; Anouk van der Winkel; David Levine; Peter Sasieni; Céline Bellenguez; Kimberley Howarth; Colin Freeman; Nigel Trudgill; Art T Tucker; Matti Pirinen; Maikel P Peppelenbosch; Luc J W van der Laan; Ernst J Kuipers; Joost P H Drenth; Wilbert H Peters; John V Reynolds; Dermot P Kelleher; Ross McManus; Heike Grabsch; Hans Prenen; Raf Bisschops; Kausila Krishnadath; Peter D Siersema; Jantine W P M van Baal; Mark Middleton; Russell Petty; Richard Gillies; Nicola Burch; Pradeep Bhandari; Stuart Paterson; Cathryn Edwards; Ian Penman; Kishor Vaidya; Yeng Ang; Iain Murray; Praful Patel; Weimin Ye; Paul Mullins; Anna H Wu; Nigel C Bird; Helen Dallal; Nicholas J Shaheen; Liam J Murray; Konrad Koss; Leslie Bernstein; Yvonne Romero; Laura J Hardie; Rui Zhang; Helen Winter; Douglas A Corley; Simon Panter; Harvey A Risch; Brian J Reid; Ian Sargeant; Marilie D Gammon; Howard Smart; Anjan Dhar; Hugh McMurtry; Haythem Ali; Geoffrey Liu; Alan G Casson; Wong-Ho Chow; Matt Rutter; Ashref Tawil; Danielle Morris; Chuka Nwokolo; Peter Isaacs; Colin Rodgers; Krish Ragunath; Chris MacDonald; Chris Haigh; David Monk; Gareth Davies; Saj Wajed; David Johnston; Michael Gibbons; Sue Cullen; Nicholas Church; Ruth Langley; Michael Griffin; Derek Alderson; Panos Deloukas; Sarah E Hunt; Emma Gray; Serge Dronov; Simon C Potter; Avazeh Tashakkori-Ghanbaria; Mark Anderson; Claire Brooks; Jenefer M Blackwell; Elvira Bramon; Matthew A Brown; Juan P Casas; Aiden Corvin; Audrey Duncanson; Hugh S Markus; Christopher G Mathew; Colin N A Palmer; Robert Plomin; Anna Rautanen; Stephen J Sawcer; Richard C Trembath; Ananth C Viswanathan; Nicholas Wood; Gosia Trynka; Cisca Wijmenga; Jean-Baptiste Cazier; Paul Atherfold; Anna M Nicholson; Nichola L Gellatly; Deborah Glancy; Sheldon C Cooper; David Cunningham; Tore Lind; Julie Hapeshi; David Ferry; Barrie Rathbone; Julia Brown; Sharon Love; Stephen Attwood; Stuart MacGregor; Peter Watson; Scott Sanders; Weronica Ek; Rebecca F Harrison; Paul Moayyedi; John de Caestecker; Hugh Barr; Elia Stupka; Thomas L Vaughan; Leena Peltonen; Chris C A Spencer; Ian Tomlinson; Peter Donnelly; Janusz A Z Jankowski Journal: Nat Genet Date: 2012-09-09 Impact factor: 38.330