title: A comparison of the clinical, demographic and psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian country.
abstract: OBJECTIVE
  To examine the clinical spectrum of gastroesophageal reflux disease (GERD) and compare erosive (ERD) with non-erosive (NERD) in terms of clinical, demographic and psychiatric profiles.
  
  
  METHODS
  Patients with reflux symptoms were enrolled and stratified to NERD and ERD after endoscopy (LA classification). Patients with ERD presenting with dyspepsia were included. Patients on proton pump inhibitors (PPI) or H2 receptor antagonists before endoscopy were excluded. Demographic data, Helicobacter pylori (H pylori) status and presence of minor psychiatric morbidity (based on General Health Questionnaire-28) were analyzed.
  
  
  RESULTS
  Among 690 patients screened, 533 were eligible for analysis (male to female ratio: 3:2; Chinese: 75.4%; Malay: 9.8%; Indian: 14.8%). Clinical spectrum of GERD: N: 40.5%; A: 46%; B: 9.2%; C: 2.1%; D: 0.6%; Barrett's esophagus: 1.7%. Compared to patients with NERD, patients with ERD were significantly older (45 vs 39.4 years), more likely to be male (64.4% vs 53.7%), tended to smoke (19.6% vs 9.7%), less likely to have minor psychiatric morbidity (26.4 vs 46.7%) and were more likely to respond to PPI (79.7 vs 66.8%). There was also a trend towards a higher BMI (24.5 vs 23.5). Race, alcohol consumption and H pylori status were not significant. On multivariate analysis, age and presence of minor psychiatric morbidity remained with significant differences.
  
  
  CONCLUSIONS
  The majority of patients who have typical symptoms of GERD have NERD or mild erosive reflux disease. Compared to patients with erosive reflux disease, patients with NERD were younger and had a higher prevalence of minor psychiatric morbidity.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore. tiing_leong_ang@cgh.com.sg
authors.forename: Tiing-Leong
authors.initials: TL
authors.lastname: Ang
authors.forename: Kwong-Ming
authors.initials: KM
authors.lastname: Fock
authors.forename: Tay-Meng
authors.initials: TM
authors.lastname: Ng
authors.forename: Eng-Kiong
authors.initials: EK
authors.lastname: Teo
authors.forename: Tju-Siang
authors.initials: TS
authors.lastname: Chua
authors.forename: Jessica
authors.initials: J
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D003710:Demography; D005006:Ethnicity; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012846:Singapore / Q000453:epidemiology