High prevalence of reflux oesophagitis among upper endoscopies of Iranian patients.

BACKGROUND AND AIM: To reinvestigate the prevalence of reflux esophagitis among upper endoscopies in a series of Iranian patients, considering the high prevalence of reflux esophagitis (76%) reported by an earlier Iranian study and the scanty data regarding prevalence of gastroesophageal reflux disease from Iran and the Middle East.

METHODS: Patients referred for upper endoscopy to an outpatient gastroenterology clinic in Tehran (May 2005-January 2006) were interviewed using a questionnaire before endoscopy. Gastroesophageal reflux disease was defined as having any degree of reflux esophagitis on endoscopy, or having heartburn or regurgitation on a weekly basis during the preceding 3 months. Reflux esophagitis was diagnosed and graded using Los Angeles classification. Check-up patients were excluded. Gastroesophageal reflux disease, nonerosive reflux disease, and reflux esophagitis groups were compared with non-gastroesophageal reflux disease patients with regard to the following factors: sex, age, body mass index (BMI), hiatus hernia, smoking, alcohol use, and level of education.

RESULTS: Out of 501 consecutive patients undergoing upper endoscopy (195 men, 306 women; mean+/-SD of age, 44.7+/-15 years; mean+/-SD of BMI, 24.9+/-4.4), 50 and 48% had reflux esophagitis with and without exclusion of the patients on acid-suppressing drugs in the past 2 weeks, respectively. Most had grade A (90%) or B (9%) reflux esophagitis. Only one patient (0.2%) had Barrett's esophagus. By Rome-II criteria, 116 had dyspepsia symptoms (predominant), of whom 41% had reflux esophagitis. High BMI (>25) and hiatus hernia both showed statistically significant associations with gastroesophageal reflux disease, whereas nonerosive reflux disease and reflux esophagitis were associated only with high BMI and hiatus hernia, respectively. Although the nonerosive reflux disease patients were of a lower education level than non-gastroesophageal reflux disease patients, no significant association of education level with gastroesophageal reflux disease and reflux esophagitis was found.

CONCLUSION: This study showed a significantly higher prevalence of reflux esophagitis among Iranian upper-endoscopy outpatients compared with the findings of non-Iranian studies.