Endoscopic assessment of gastroesophageal reflux disease patients and risk factors of esophageal lesions

Abstract

Background: Gastro-esophageal reflux disease (GERD) is a common esophageal disorder in Bangladesh. GERD is associated with significant impaired quality of life and sometimes complicated with high morbidity and mortality. Objective: To investigate upper Gl endoscopic findings in patients having typical symptoms of GERD and the risk factors of esophageal lesions in GERD patients. Methods: This was a cross-sectional descriptive type of study conducted at a private clinic in Rajshahi city. All the adults attending at the clinic having typical GERD symptoms more than 6 weeks constituted the study population. Total 108 GERD patients were included in this study. Data were collected by a data collection sheet through interview and patient examination including UGI endoscopy. Chi-square test was applied to find out the association between Clinico-demographic characteristics and GERD status of the study subjects. Multiple logistic regression analysis was done to identify the risk factors to develop esophageal lesion in GERD patients. Results: A total of 108 GERD patients, 88 (81.5%) were nonerosive reflux disease (NERD) patients and the rest 20 (18.5%) patients had esophageal lesions. Of those 20 GERD patients with esophageal lesion, 9 (8.3%) had erythema, 5 (4.6%) had erosion, 4 (3.6%) had hiatus hernia with esophagitis and only 2 (1.8%) had Barretts. Twenty-four (22.2%) patients had endoscopic evidence of gastroduodenal lesions. Older age and diabetes mellitus were identified as risk factors of esophageal lesion. Conclusion: Gastroduodenal lesions may be an important underlying cause for GERD in Bangladesh. UGI endoscopy should be performed routinely in GERD patients. Special consideration should be taken during the management of GERD in elderly and diabetic patients.