THE PREVALENCE OF ENDOSCOPIC ESOPHAGITIS IN DUODENAL-ULCER PATIENTS AND SYMPTOMATIC CONTROLS

Background: A large series of duodenal ulcer patients was examined in order to determine the prevalence rate of reflux esophagitis and compa re it to that of a series of symptomatic controls, as well as to find out if complicated duodenal ulcer patients are at a higher risk of dev eloping reflux esophagitis. Patients and Methods: All consecutive pati ents attending the Endoscopy unit between January and December 1996 wh o were found to have duodenal ulcers were prospectively recruited fdr this study. Consecutive patients with upper abdominal symptoms but neg ative gastroscopy for duodenal ulcers were used as a control. Patients known to have reflux esophagitis, those on peptic ulcer treatment for more than a week, those with dysphagia as a presenting symptom or und erlying upper gastrointestinal malignancy, and patients who had underg one previous ulcer surgery were excluded from the study. A hundred and ferry-one patients were found to have duodenal ulcer (Group I) and on e hundred and seventy-two served as a control (Group II). The two grou ps were matched for age, NSAID ingestion and smoking habit. However, G roup I included significantly more patients with underlying co-morbid conditions and fewer females. Results: The prevalence of reflux esopha gitis was similar between both groups, 30.5% vs. 38.4%, P = 0.18. Furt hermore, bleeding duodenal ulcer patients (sub-group III) were compare d to non-bleeding duodenal ulcer patients (sub-group IV). Although Gro up III included significantly more smokers, NSAID ingestion and comorb id conditions, there was no significant difference in the prevalence r ate of reflux esophagitis, P = 0.13. Moreover, 92.7% of afflicted pati ents suffer mild or moderate esophagitis. Conclusion: Endoscopic esoph agitis is a frequent finding in both duodenal ulcer and control subjec ts.