Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites.
OBJECTIVE
To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications.


METHODS
A retrospective search of the endoscopy database at the University of Florida Health Science Center/Jacksonville for all cases of reflux esophagitis and its complications from January 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classification, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication.


RESULTS
The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001).


CONCLUSIONS
Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture and hiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.
Vega
Kenneth J
KJ
Divisions of Gastroenterology and General Internal Medicine, University of Florida Health Sciences Center, Jacksonville, Florida 32207, United States. kenneth.vega@jax.ufl.edu
Chisholm
Sian
S
Jamal
M Mazen
MM
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000208:ethnology / Q000209:etiology; D004942:Esophagitis, Peptic / Q000150:complications* / Q000208:ethnology* / Q000473:pathology / Q000503:physiopathology; D004945:Esophagoscopy; D005260:Female; D006356:Heartburn / Q000208:ethnology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult