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World J Gastrointest Endosc. Apr 16, 2011; 3(4): 71-77
Published online Apr 16, 2011. doi: 10.4253/wjge.v3.i4.71
Assessment of gastroesophageal reflux disease by serodiagnosis of Helicobacter pylori-related chronic gastritis stage
Shotaro Enomoto, Masashi Oka, Hiroshi Ohata, Chizu Mukoubayashi, Mika Watanabe, Kosaku Moribata, Yosuke Muraki, Naoki Shingaki, Hisanobu Deguchi, Kazuki Ueda, Izumi Inoue, Takao Maekita, Mikitaka Iguchi, Kimihiko Yanaoka, Hideyuki Tamai, Mitsuhiro Fujishiro, Osamu Mohara, Masao Ichinose
Shotaro Enomoto, Masashi Oka, Chizu Mukoubayashi, Mika Watanabe, Kosaku Moribata, Yosuke Muraki, Naoki Shingaki, Hisanobu Deguchi, Kazuki Ueda, Izumi Inoue, Takao Maekita, Mikitaka Iguchi, Kimihiko Yanaoka, Hideyuki Tamai, Masao Ichinose, Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, Japan
Hiroshi Ohata, Osamu Mohara, Wakayama Wellness Foundation, Wakayama 640-8404, Japan
Mitsuhiro Fujishiro, Department of Endoscopy and Endoscopic Surgery, Faculty of Medicine, University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Enomoto S carried out the data analyses and drafted the manuscript. Ohata H, Mukoubayashi C, Watanabe M, Deguchi H and Yanaoka K carried out endoscopic examinations of the study subjects. Moribata K, Muraki Y, Shingaki N, Ueda K, Inoue I, Maekita T, Iguchi M, Tamai H, Fujishiro M and Mohara O contributed to critical review of the article. Oka M and Ichinose M contributed to the conception and design of the study and also made a substantial contribution to data acquisition. All authors read and approved the final manuscript.
Correspondence to: Shotaro Enomoto, MD, PhD, Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama-city, Wakayama 641-0012, Japan. shoe@orion.ocn.ne.jp
Telephone: +81-73-447-1335 Fax: +81-73-445-3616
Received: December 14, 2010
Revised: February 23, 2011
Accepted: March 2, 2011
Published online: April 16, 2011
AIM: To evaluate the association of Helicobacter pylori (H.pylori)-related chronic gastritis stage with upper gastrointestinal symptoms and gastroesophageal reflux disease (GERD).
METHODS: Subjects underwent upper gastrointestinal endoscopy, a questionnaire using a frequency scale for symptoms of GERD (FSSG), and measurements of serum H.pylori-antibody and pepsinogen (PG) levels. They were classified into the following 4 groups in terms of H.pylori-related chronic gastritis stage: Group A (n = 219), H.pylori(-)PG(-); Group B (n = 310), H.pylori(+)PG(-); Group C (n = 279), H.pylori(+)PG(+); and Group D (n = 17), H.pylori(-)PG(+).
RESULTS: Reflux esophagitis occurred in 30.6% of Group A, 14.5% of Group B, 6.8% of Group C, and 0% of Group D (P < 0.001). Scores for acid reflux symptoms decreased significantly with chronic gastritis stage (from Group A to D) (P < 0.05), while scores for dysmotility symptoms did not differ significantly. The prevalence of non-erosive reflux disease (NERD) did not differ among groups. However, in subjects with GERD, the prevalence of NERD tended to increase with chronic gastritis stage (P = 0.081).
CONCLUSION: Acid reflux symptoms and the prevalence of reflux esophagitis can be assessed by measuring both serum H.pylori-antibody and PG levels.
