title: Characteristics of gastroesophageal reflux disease in Japan: increased prevalence in elderly women.
abstract: The aim of this study was to examine the characteristics of gastroesophageal reflux disease in Japan. We evaluated the correlation between clinical symptoms and endoscopic findings in an age- and sex-specific manner. This study included 6010 Japanese subjects who had not received medication or undergone laparotomy for gastrointestinal disease. All subjects were questioned in regard to clinical symptoms by paramedical personnel before endoscopic examination. Esophageal mucosal breaks were evaluated according to the Los Angeles Classification of Esophagitis. The ratio of subjects with each complaint to all subjects is as follows: heartburn, 27.0%; dysphagia, 16.9%; odynophagia, 19.2%; acid regurgitation, 7.1%. The proportion of each grade was grade A, 9.6%; grade B, 4.6%; and grade C + D, 2.0%. The most common related symptom for endoscopic esophagitis among these four symptoms was heartburn (odds ration, 2.5), although about 40% of subjects with severe esophagitis of grade C or D did not complain of heartburn. Regarding odynophagia, acid regurgitation, and dysphagia, odds ratios were about 1.0. The age-related ratio of esophagitis and severe disease with grades C and D increased in women over 60 years of age. An age-related slouched position was related to the increased esophagitis in these elderly women. Male subjects whose body mass index was more than 25 tended to show a greater prevalence in the age group 30-50 years. The prevalence of hiatal herniation increased in an age-related manner. These data indicate the characteristics of esophagitis in Japan are as follows: (1) the prevalence of reflux esophagitis is about 15% and most of these cases are grade A or B; and (2) the prevalence of severe esophagitis increases in older women, who do not always complain of clinical symptoms.
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga 849-8501, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Okamoto
authors.forename: Kayoko
authors.initials: K
authors.lastname: Oda
authors.forename: Akiko
authors.initials: A
authors.lastname: Tanaka
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kikkawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Shin
authors.initials: S
authors.lastname: Nakahara
authors.forename: Hibiki
authors.initials: H
authors.lastname: Ootani
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ootani
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D004942:Esophagitis, Peptic / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution