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Background:Gastroesophageal reflux disease questionnaire(GerdQ)is a potentially useful tool for diagnosis of gastroesophageal reflux disease(GERD). Reflux esophagitis(RE)is a clinical type of GERD characterized by endoscopic mucosal injury of esophagus. Aims:To study the correlation of GerdQ score with severity of RE. Methods:Patients with typical reflux-related symptoms and meeting the inclusion criteria were recruited consecutively from Department of Gastroenterology,the People's Hospital of Xinjiang Uygur Autonomous Region during Aug. 2014 to Dec. 2015. All patients recruited were asked to complete the GerdQ scoring scale,meanwhile,the demographic information was collected and an upper gastrointestinal endoscopy was performed. The severity of RE was graded endoscopically by Los Angeles classification system. Results:A total of 1 554 patients were enrolled in this study,664 with RE(RE group)and 890 without RE(control group). The proportion of males in RE group was significantly higher than those in control group (50.9% vs. 37.1%,P<0.05). The prevalence of RE was significantly higher in Uygur than in Han and other ethnics (48.5% vs. 40.5% and 39.3%,P all <0.05). The proportions of patients with RE rose up with the increase of GerdQ score in a cut-off range from 0-14(0%,19.7%,50.1% and 51.7% for 0-2,3-7,8-11 and 11-14,respectively). The mean GerdQ score was significantly higher in RE group than in control group(9.95 ± 2.76 vs. 9.09 ± 3.33,P<0.05), and GerdQ score was positively correlated with severity of RE(r=0.243,P<0.05). When stratified by nationality,the correlation of GerdQ score with severity of RE was unchanged. Conclusions:GerdQ is a useful complementary tool for the diagnosis of RE. A cut-off value of 8 might predict the presence of RE and the GerdQ score might reflect the disease severity.
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Objective To investigate the changes of esophageal intraluminal baseline impedance in patients with refluxesophagitis.Methods From December 2013 to August 2014,47 patients with reflux esophagitis and 17 healthy controls were enrolled.The patients with reflux esophagitis were graded according to Los Angeles classification (LA) grading standards.All subjects accepted 24 h multichannel intraluminal impedance (MII) pH examination,and the baseline value of impedance were measured.Independent sample t test was used to compare the difference in impedance between the two groups.Spearman rank correlation coefficient was performed to analyze the correlation between acid exposure time (AET) and the baseline impedance of patients with reflux esophagitis.Kruskal-Wallis test was used to compare the differences in baseline impedance of patients with different grades of reflux esophagitis.Results The impedance baseline value of reflux esophagitis group was (1 676.72±644.41) Ω,which was lower than that of healthy control group ((2 151.27± 322.05) Ω),and the difference was statistically significant (t =-3.883,P＜0.01).The AET of esophagus was negatively correlated with the baseline impedance of the patients with reflux esophagitis (r=-0.530,P＜0.01).The baseline impedance of patients with grade LA-A and grade LA-B reflux esophagitis were 1 823.62 Ω (1 515.38 52 Ω,2 208.38 Ω) and 1 771.81 Ω(1 304.75 52 Ω,2 080.50 Ω),respectively,and the difference was not statistically significant (Z=-0.630,P=0.529).The baseline impedance of patients with grade LA C/D reflux esophagitis was 300 Ω (300 Ω,500 Ω),which was obviously lower than those of patients with grade LA-A or grade LA-B (Z=-2.647 and-2.818,both P＜0.017).Conclusion The baseline impedance of patients with reflux esophagitis is low and correlated with AET.
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Background and aim The relationship between gastroesophageal reflux disease (GERD) and Helicobacter pylori is controversial. We evaluated endoscopic, 24-h gastric and esophageal acid profile among patients with GERD in relation to H. pylori, as the latter might alter gastric acid secretion. Methods Patients with GERD (n=123), who were not on acid-suppressive drugs, and had not received anti-H. pylori therapy, underwent gastroduodenoscopy and tests for H. pylori detection. Esophageal manometry, 24-h pH metry, serum pepsinogen-I (PG-I), PG-II and gastrin-17 ELISA were done in all these patients. Univariate and multivariate analyses were performed to assess independent predictors for erosive esophagitis (EE). Results Of 123 patients (mean age 40.5 [13.1] years, 85 [69.1%] men), 59 (47.9%) had H. pylori infection. EE was more common in H. pylori non-infected than infected (49 vs. 32, p<0.001). Among patients older than 40 years, absence of H. pylori was associated with lower esophageal pH and longer reflux (p=0.02 and p<0.001, respectively). PG-I/PG-II ratio was lower in H. pylori infected subjects (p <0.001). In patients with higher LA grade of esophagitis, elevated PG-I levels and PG-I/PG-II ratio were associated with more acidic stomach (p=0.04 and p=0.01, respectively). Multivariate analyses showed low gastrin-17 (p=0.016), higher age (p=0.013), hiatus hernia (p=0.004) and absence of H. pylori (p=0.03) were independent predictors for risk of EE. Conclusion H. pylori infection is associated with less acidic stomach and less severe GERD. Low gastrin-17, higher age, hiatus hernia and absence of H. pylori were the best predictors for EE risk.