Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2022; 28(8): 853-867
Published online Feb 28, 2022. doi: 10.3748/wjg.v28.i8.853
Inverse correlation between gastroesophageal reflux disease and atrophic gastritis assessed by endoscopy and serology
Yoo Min Han, Su Jin Chung, Seokha Yoo, Jong In Yang, Ji Min Choi, Jooyoung Lee, Joo Sung Kim
Yoo Min Han, Su Jin Chung, Jong In Yang, Ji Min Choi, Jooyoung Lee, Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul 06236, South Korea
Seokha Yoo, Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, South Korea
Joo Sung Kim, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
Author contributions: Han YM, Chung SJ designed and performed the research and wrote the paper; Yoo S designed the research and contributed to the analysis; Yang JI, Choi JM, Lee J collected the patients’ clinical data and provided clinical advice; Kim JS provided clinical advice and supervised the report; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the International Review Board of Seoul National University Hospital (IRB No. H-1701-028-655).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data. Written informed consent was waived by the Ethics Committee of the designated hospital.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: Some or all data and code generated or used during the study are available from the corresponding author by 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:
Corresponding author: Su Jin Chung, MD, PhD, Professor, Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 39th floor, GFC building 152, Teheran Ro, Gangnam-gu, Seoul 06236, South Korea.
Received: August 13, 2021
Peer-review started: August 13, 2021
First decision: October 2, 2021
Revised: October 29, 2021
Accepted: January 19, 2022
Article in press: January 19, 2022
Published online: February 28, 2022
Research background

Helicobacter pylori (H. pylori) infection is known to prevent the occurrence of gastroesophageal reflux disease (GERD) by inducing gastric mucosal atrophy. However, little is known about the relationship between atrophic gastritis (AG) and GERD.

Research motivation

Our study directly focused on AG as a protective factor of GERD, which was more fundamental and systematic approach to show how H. pylori infection affects GERD.

Research objectives

We aimed to confirm the inverse correlation between AG and the occurrence and severity of GERD.

Research methods

We assessed AG in two independent methods, endoscopy and serology, furthermore, investigated variety of possible risk factors for GERD based on laboratory examination and structured questionnaires.

Research results

Advanced age, male sex, body mass index > 23 kg/m2, presence of metabolic synd-rome, current smoking, and alcohol consumption were associated with an increased risk of GERD. Seropositivity for H. pylori immunoglobulin G antibodies was associated with a decreased risk of GERD. There was an inverse correlation between the extent of endoscopic AG (EAG) and occurrence of GERD. Additionally, the extent of EAG showed an inverse correlation with the severity of GERD. The presence of serologic AG (SAG) was correlated with a reduced risk of GERD.

Research conclusions

The extent of EAG and SAG exhibited strong inverse relationships with the occurrence and severity of GERD. AG followed by H. pylori infection may be independently protect against GERD.

Research perspectives

As the Kimura-Takemoto visual endoscopic method used in our study might be subjective, it would be better to continue further study using the endoscopic morphological method - Updated Kimura-Takemoto classification of AG. Furthermore, to clarify the causality between AG and GERD, prospective studies are warranted to follow how the prevalence and severity of GERD change according to the progression or regression of AG.