Mengistie FA, Shewaye AB, Tasamma AT, Ayalew ZS. Clinical features of gastroesophageal reflux disease and erosive esophagitis: Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia. World J Gastroenterol 2024; 30(34): 3883-3893 [DOI: 10.3748/wjg.v30.i34.3883]
Corresponding Author of This Article
Firehiwot A Mengistie, MD, Chief Physician, Department of Internal Medicine, Addis Ababa University, Churchill St., Addis Ababa 1176, Addis Ababa, Ethiopia. firehiwotabebe671@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 14, 2024; 30(34): 3883-3893 Published online Sep 14, 2024. doi: 10.3748/wjg.v30.i34.3883
Clinical features of gastroesophageal reflux disease and erosive esophagitis: Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia
Firehiwot A Mengistie, Abate B Shewaye, Abel T Tasamma, Zekarias S Ayalew
Firehiwot A Mengistie, Abate B Shewaye, Abel T Tasamma, Zekarias S Ayalew, Department of Internal Medicine, Addis Ababa University, Addis Ababa 1176, Addis Ababa, Ethiopia
Firehiwot A Mengistie, Department of Internal Medicine, Rheum Rheumatology and Internal Medicine Specialty Clinic, Addis Ababa 1000, Addis Ababa, Ethiopia
Abate B Shewaye, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Adera Medical and Surgical Center, Addis Ababa 1000, Addis Ababa, Ethiopia
Co-corresponding authors: Firehiwot A Mengistie and Zekarias S Ayalew.
Author contributions: Mengistie FA and Ayalew ZS contribute equally to this study as co-corresponding authors. Mengistie FA and Shewaye AB contribute to the conceptualization, methodology, investigation, analysis, and writing of the manuscript; Tasamma AT and Ayalew ZS contribute to the methodology, data curation, drafting, interpretation, and edition of the data and supervision, supervision, and edition of the manuscript.
Institutional review board statement: The ethical clearance of the study was obtained from the Institutional Review Board of Addis Ababa University, College of Health Sciences.
Informed consent statement: Consent forms have been acquired from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The dataset is available from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Firehiwot A Mengistie, MD, Chief Physician, Department of Internal Medicine, Addis Ababa University, Churchill St., Addis Ababa 1176, Addis Ababa, Ethiopia. firehiwotabebe671@gmail.com
Received: May 22, 2024 Revised: August 24, 2024 Accepted: August 30, 2024 Published online: September 14, 2024 Processing time: 110 Days and 12.2 Hours
Abstract
BACKGROUND
Gastroesophageal reflux disease (GERD) is a common disease worldwide with varying clinical presentations and risk factors. Prevalence data for Africa is lacking, but an increasing trend is expected due to demographic and epidemiological transitions. Although endoscopic studies for general gastrointestinal disorders have shown some patients with erosive esophagitis (EE), no studies in Ethiopia have investigated the clinical characteristics, risk factors, and severity of GERD using esophagogastroduodenoscopy (EGD).
AIM
To assess the clinical features of GERD in Ethiopian patients who underwent EGD and determine the severity and risk factors of EE.
METHODS
We conducted a multicenter, retrospective cross-sectional study of 221 patients diagnosed with GERD and endoscopic findings of EE at Trauma Associated Severe Hemorrhage and Amniotic Membrane Stem Cell between January 2019 and August 2022. Data were collected from electronic medical records and phone call interviews. We used descriptive statistics and binary logistic regression analysis with SPSS version 26 to identify the association between variables with a statistical significance set at P value < 0.05.
RESULTS
The mean ± SD age of the patients was 44.8 (± 15.9) years, with a male-to-female ratio of 1.6:1. The most commonly reported symptom was epigastric pain (80.5%), followed by heartburn (43%). Los Angeles (LA)-A EE was diagnosed in 71.1% of patients, followed by LA-B (14.9%), LA-C (7.7%), and LA-D (5.9%). Multivariate analysis showed that age 50 or above, presence of bleeding, and endoscopic findings of duodenitis/duodenopathy were significantly associated with severe EE (P < 0.05). Stricture and Barrett’s esophagus were observed in 4.5% and 1.36% of patients with EE, respectively.
CONCLUSION
Most of the patients had milder EE with fewer complications. However, severe EE was more prevalent in older patients and those with duodenitis/duodenopathy.
Core Tip: This multicenter study in a resource-limited setting identified risk factors for severe erosive esophagitis (EE) in patients with gastroesophageal reflux disease (GERD) undergoing esophagogastroduodenoscopy. Age 50 years or above, bleeding, and duodenitis/duodenopathy were associated with worse EE. These findings can inform risk stratification for patients with GERD in similar settings.
