title: Alcohol and tea consumption are associated with asymptomatic erosive esophagitis in Taiwanese men.
abstract: OBJECTIVE
  Asymptomatic erosive esophagitis (AEE) is commonly found in men, and might be a risk factor of developing esophageal adenocarcinoma. We aimed to determine if specific dietary habits increase the risk of AEE in asymptomatic Taiwanese men.
  
  
  METHODS
  We recruited male adults undergoing upper gastrointestinal endoscopy for health check. We excluded subjects with reflux symptoms, or taking anti-reflux medications or drugs that potentially impair lower esophageal sphincter function or cause mucosal injury. The frequency of consuming reflux-provoking diets including alcohol, tea, coffee, tomato/citric juice, chocolate, sweet food, and spicy food was assessed. The erosive esophagitis was diagnosed based on the Los Angeles Classification after endoscopy. Frequent consumption of a specific diet was defined as ≥4 days/week of consuming that diet.
  
  
  RESULTS
  A total of 1256 participants were recruited. After excluding 424 ineligible subjects, AEE was identified in 180 (22%) among 832 asymptomatic subjects. The risk of AEE increased with the number of days per week of consuming alcohol or tea: nondrinkers (19%, 17%), occasional drinkers (<1 day/week; 19%, 15%), regular drinkers (1-3 days/week; 26%, 21%), frequent drinkers (4-6 days/week; 32%, 22%), and daily drinkers (42%, 28%), respectively (trend test P < 0.001 for both). Multivariate analysis showed that hiatus hernia (adjusted odds ratio (aOR) 5.0, 95% confidence interval (CI) 2.6-9.6), drinking alcohol ≥4 days/week (aOR 2.3, 95% CI 1.3-4.0), and drinking tea ≥4 days/week (aOR 1.6, 95% CI 1.1-2.3) are independent risk factors of AEE. The risk of AEE was 3.8 times greater for those drinking both alcohol and tea ≥4 days/week than the non-drinkers.
  
  
  CONCLUSIONS
  Frequent alcohol and tea consumption increased the risk of AEE in Taiwanese men.
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chung-Hsin
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Health Examination Center, China Medical University Hospital, Taichung, Taiwan.|Preventive Medicine Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Pin
authors.initials: CP
authors.lastname: Wu
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shou-Wu
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Chi-Sen
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hong-Zen
authors.initials: HZ
authors.lastname: Yeh
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chung-Wang
authors.initials: CW
authors.lastname: Ko
authors.affiliation: Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.|Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Han-Chung
authors.initials: HC
authors.lastname: Lien
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D058070:Asymptomatic Diseases; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005247:Feeding Behavior; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D062486:Public Health Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D013662:Tea / Q000009:adverse effects*
chemical_list: D013662:Tea