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Endoscopic reflux esophagitis in patients with upper abdominal pain‐predominant dyspepsia
Author(s) -
Song Ho June,
Choi Kee Don,
Jung HwoonYong,
Lee Gin Hyug,
Jo Ji Yun,
Byeon JeongSik,
Yang SukKyun,
Hong WeonSeon,
Kim JinHo
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04678.x
Subject(s) - heartburn , medicine , gastroenterology , reflux esophagitis , gerd , esophagitis , regurgitation (circulation) , reflux , abdominal pain , epigastric pain , disease , vomiting
Abstract Background: Reflux symptom assessment had reliable accuracy in the diagnosis of gastroesophageal reflux disease (GERD). However, patients may recognize heartburn or regurgitation as dyspepsia because of inaccurate understanding or atypical presentation. The aim of the present study was to estimate endoscopic reflux esophagitis in patients with upper abdominal pain as a predominant symptom in the absence of heartburn or regurgitation. Methods: Two hundred and sixty‐three consecutive patients presenting dyspepsia without heartburn or regurgitation were enrolled. Patients with heartburn or regurgitation were excluded using the symptom interviewer method. Dyspepsia was categorized into pain‐predominant or dysmotility‐predominant groups according to the Rome II proposal. Endoscopic reflux esophagitis was graded using the Los Angeles classification. Results: One hundred and five patients were included in the pain‐predominant group and 119 in the dysmotility‐predominant group. Reflux esophagitis was found in 18.8% (42/224) of all dyspeptic patients. Grade A esophagitis was noted in 27.6% (29/105) of the pain‐predominant group and in 7.6% (9/119) of the dysmotility‐predominant group. Grade B was noted in two patients in each group. A total of 29.5% (31/105) and 9.3% (11/119) had reflux esophagitis, respectively ( P < 0.001). Comparing patients with or without reflux esophagitis, there was no difference in body mass index, smoking habit, alcohol consumption, or Helicobacter pylori infection status. Conclusions: A significant proportion of patients presenting dyspepsia, especially pain‐predominant dyspepsia, have endoscopic reflux esophagitis. In view of GERD, pain‐predominant dyspepsia should be investigated and managed differently from dysmotility‐predominant dyspepsia.