Lower esophagus in dyspeptic Iranian patients: a prospective study.
BACKGROUND
Gastroesophageal junction cancer has increased over time in Western countries. Gastroesophageal reflux disease (GERD) is considered to be a major risk factor. We prospectively studied the prevalence of clinical, histological and endoscopic GERD, and premalignant changes among dyspeptic Iranian patients referred for upper gastrointestinal endoscopy (UGIE).


METHODS
Consenting patients referred for UGIE to our clinic were enrolled. Their symptoms were recorded, UGIE was conducted, and biopsies from all suspicious lesions and across the Z-line were taken.


RESULTS
Of the 344 enrolled patients, 269 (135 women, 134 men; mean age: 41.6 years) were evaluated. One major GERD symptom (heart burn, acid regurgitation, dysphagia and chest pain) was seen in 209 (77.6%) patients, and 207 patients (76.1%) had endoscopic esophagitis. Thirteen patients (5%) had specialized intestinal metaplasia at the gastrointestinal junction (SIM-GEJ), and three had glandular dysplasia (two low-grade, one high-grade). No symptom could predict the presence of histological or endoscopic findings. Patients with dysplasia had more advanced degrees of endoscopic esophagitis.


CONCLUSIONS
Gastroesophageal reflux disease is common among Iranian patients referred for diagnostic endoscopy. The prevalence of SIM-GEJ among this population was comparable to that reported in Western countries.
Nasseri-Moghaddam
Siavosh
S
Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. sianm@ams.ac.ir
Malekzadeh
Reza
R
Sotoudeh
Masoud
M
Tavangar
Mohammad
M
Azimi
Kourosh
K
Sohrabpour
Amir-Ali
AA
Mostadjabi
Pardis
P
Fathi
Hosnieh
H
Minapoor
Mina
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000175:diagnosis / Q000473:pathology*; D001471:Barrett Esophagus / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D007492:Iran; D008297:Male; D008679:Metaplasia / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013223:Statistics as Topic