General gastroscopy of gastroesophageal reflux disease: Analysis of 4086 cases / 解放军医学杂志

ABSTRACT

Objective To analyze the characteristics ofgastroesophageal reflux disease (GERD) under general gastroscope.Methods The detection rates of GERD related abnormalities such as esophagitis,Barrett esophagus and hiatal hernia under the first gastroscopy of the adult GERD patients from January 2013 to January 2017 in our center and the statistical relationship between the abnormal findings were analyzed retrospectively.Results A total of 4086 GERD patients,2004 males and 2082 females,were included in this study,and the age was 18-89(50.4 ± 13.3) years old.The detection rate of non erosive GERD was 78.7％,esophagitis 21.3％;non Barrett esophagus 87.7％,suspected Barrett esophagus 8.3％,Barrett esophagus 3.9％;generally normal cardia 61.4％,short segment hiatus hernia 20.4％,and long segment hiatal hernia 18.2％.The detection rates of esophagitis showed statistically significant differences (P＜0.001) between the three groups of generally normal cardia,short segment hiatal hernia and long segment hiatal hernia;The detection rate of Barrett esophagus was significantly higher in long segment hiatal hernia group than in generally normal cardia group and short segment hiatal hernia group (P＜0.001,P=0.012),but the difference between the later two groups was not statistically significant (P＞0.013).Comparing the three age groups of 18-39,40-59 and ≥60 years old,the detection rate of hiatal hernia was significantly higher in the group of≥60 years old than in the 18-39 and 40-59 years old groups (P=0.007),while there was no significant difference (P＞0.013) between the 18-39 and 40-59 years old groups.The detection rate of esophagitis was significantly higher in ≥60 years old group than in 18-39 and 40-59 years old groups (P=0.004,P=0.008),while no significant statistically difference (P＞0.013) was found between the later two groups.Conclusions Gastroscopy can be used as a basic examination means for GERD;short segment hiatal hernia can be regarded as an early form of hiatal hernia,and is of important reference value for the diagnosis and treatment of GERD;more serious hiatal hernia and esophagitis could be found in elderly GERD patients.