Economic and Social Barriers to Effective GERD Treatment After H. pylori in Racially Diverse Populations

Aims Race and gender significantly impact GERD symptoms after H. pylori treatment, influenced by biological, cultural, and socioeconomic factors. This complexity underscores the need for personalized treatment strategies to ensure equitable health outcomes and improve GERD management in diverse populations post-H. pylori eradication. Understanding these disparities is vital for advancing personalized medicine.

Methods From 2009 to 2023, our retrospective study investigated patients treated for H. Pylori with a focus on the onset of GERD symptoms, Esophagitis, and duodenal ulcers, using CPT and ICD codes for accurate disease identification. We analyzed factors such as comorbidities, insurance, and socioeconomic status alongside demographic data like gender and race. Using Chi-square tests, we explored the relationship between race and GERD symptoms, confirming significant associations. Further post-hoc analysis with adjusted residuals helped identify specific racial groups with varying frequencies of GERD symptoms, enhanced by pairwise comparisons and Bonferroni corrections for accuracy.

Results Between 2009 and 2023, 4,205 patients received H. Pylori treatment, with 3,329 qualifying for our study after excluding those lost to follow-up. The average age was 54.5 years, with 64% female (2,134) and 48% Caucasian (1,664). The Chi-square test revealed a significant association between Race and GERD symptoms (Chi sq stat:8.69 p-value<0.01). In-depth post-hoc pairwise comparisons showed that the Hispanic race had significantly higher rates of GERD symptoms when compared to other races, with the most notable differences observed against Other (p<0.01), White (p<0.01), Black (p<0.01), and Asian races (< 0.01). Adjusted residual analysis further confirmed that the Hispanic race (5.54, p<0.023) showed a higher-than-expected number of GERD symptom cases. Among the Hispanic races, Patients with low socioeconomic status showed increased GERD symptoms (Chi.Sq: 7.65, P<0.01). Gender does not significantly impact GERD symptoms (Chi.sq: 0.831, P=0.512).

Conclusions Our 2009-2023 study on H. Pylori-treated patients reveals race and gender significantly impact GERD symptoms post-treatment, with Hispanics showing higher incidence rates. Socioeconomic status exacerbates this trend, underscoring the necessity for personalized, culturally sensitive healthcare approaches. This highlights the importance of considering race, gender, and socioeconomic factors in managing GERD post-H. Pylori eradication.

Publication History

Article published online:
27 March 2025