Ethnic differences in gastro-oesophageal reflux disease

Objectives To see whether the anecdotal statement that gastro-oesophageal r eflux disease is less common in blacks than in white Caucasians is true. Design Study of the racial origin of adult patients who, at endoscopy, have oesophageal damage due to gastrooesophageal reflux, Setting Gastroenterology unit of a teaching hospital in inner city Birmingh am, UK. Main outcome measure Ethnicity and endoscopic grade of oesophageal damage ( reflux oesophagitis) were recorded in every patient in whom oesophageal dam age due to gastro-oesophageal reflux was diagnosed. Results Over the eight-year period 1989-1996, 1101 patients with endoscopic ally diagnosed grades I-V reflux oesophagitis have been seen, of whom 893 ( 81.9%) were white. 156 (14%) were Indian and 52 (5%) were Afro-Caribbeans, There were fewer patients with reflux oesophagitis from the two non-white e thnic groups than would be expected from their prevalence in the catchment population, and severe reflux oesophagitis was less common than expected in the two non-white groups. In all groups, patients with grades III, IV and V reflux oesophagitis were older than patients with grades I and II disease . Whites tended to be older than Afro-Caribbeans or Indians, Conclusion There were fewer non-whites with reflux oesophagitis than would be expected but the reasons for this are unclear. This study has been usefu l as a pilot but further studies are needed in ethnically mixed non-migrant populations both in hospital, primary care and the community to clarify ra cial differences in reflux oesophagitis. Eur Gastroenterol Hepatol 11:735-7 39 (C) 1999 Lippincott Williams & Wilkins.