Real-world prevalence of endoscopic findings in patients with gastroesophageal reflux symptoms: a cross-sectional study

Simcha Weissman; Abimbola Chris-Olaiya; Andrew T. Weber; Tej I. Mehta; Bryan Doherty; Vinod Nambudiri; Adam Atoot; Muhammad Aziz; James H. Tabibian

doi:10.1055/a-1756-4594

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E342-E346
DOI: 10.1055/a-1756-4594

Original article

Real-world prevalence of endoscopic findings in patients with gastroesophageal reflux symptoms: a cross-sectional study

Authors

Simcha Weissman‡

¹Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, New Jersey, United States
Abimbola Chris-Olaiya‡

²Division of Digestive Diseases, University of Kentucky Medical Center, Lexington, Kentucky, United States
Andrew T. Weber

³Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
Tej I. Mehta

⁴Department of Radiology, Johns Hopkins University Hospital, Baltimore, Maryland, United States
Bryan Doherty

⁵Department of Medicine, New-York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States
Vinod Nambudiri

⁶Department of Medicine, Grand Strand Medical Center, Myrtle Beach, South Carolina, United States
Adam Atoot

¹Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, New Jersey, United States
Muhammad Aziz

⁷Division of Gastroenterology, University of Toledo Medical Center, Toledo, Ohio, United States
James H. Tabibian

³Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

⁸Division of Gastroenterology, Olive View-UCLA Medical Center, Sylmar, California, United States

Abstract

Background and study aims Data regarding endoscopic findings and symptom correlation in patients with gastroesophageal reflux disease (GERD) symptoms are largely limited to single-center experiences. We performed a nationwide study to examine the association between patient-reported GERD symptoms and clinically relevant endoscopic findings.

Patients and methods Using the National Endoscopic Database, we retrospectively identified all esophagogastroduodenoscopies (EGDs) performed for GERD symptoms from 2000 to 2014. Patients were categorized into three symptom groups: 1) typical reflux only (R); 2) airway only (A); and 3) both R and A (R + A). Outcomes were the point prevalence of endoscopic findings in relation to patient-reported GERD symptom groups. Statistical analyses were performed using R.

Results A total of 167,459 EGDs were included: 96.8 % for R symptoms, 1.4 % for A symptoms, and 1.8 % for R + A symptoms. Of the patients, 13.4 % had reflux esophagitis (RE), 9.0 % Barrett’s esophagus (BE), and 45.4 % hiatal hernia (HH). The R + A group had a significantly higher point prevalence of RE (21.6 % vs. 13.3 % and 12 %; P < 0.005) and HH (56.9 % vs. 45.3 % and 38.3 %; P < 0.005) compared to the R or A groups, respectively. The R group had a significantly higher point prevalence of BE compared to the A or R + A groups, respectively (9.1 % vs. 6.1 % and 6.1 %, P < 0.005).

Conclusions On a national level, patients experiencing R + A GERD symptoms appear more likely to have RE and HH, while those with only R symptoms appear more likely to have BE. These real-world data may help guide how providers and institutions approach acid-suppression therapy, set thresholds for recommending EGD, and develop management algorithms.

Full Text

References

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