Proportion of reflux esophagitis in 6010 Japanese adults: prospective evaluation by endoscopy

Compared with findings in Western countries, the prevalence of reflux esoph agitis in Oriental countries is estimated to be low. In this prospective st udy, we aimed to examine the proportion of reflux esophagitis in Japanese a dults, as evaluated by endoscopy. Endoscopists were prospectively directed to grade esophageal mucosal breaks with esophagitis according to the Los An geles Classification of Esophagitis in all subjects that underwent endoscop ic examination. In total, 6010 subjects underwent endoscopic examination fo r evaluation of esophagitis grading from December 1996 to February 1998. Th e subjects included 4394 outpatients who were not receiving medication for gastrointestinal disease and 1616 subjects who visited the hospital for rou tine physical examinations. The overall proportion of esophagitis was 16.3% . Most of the subjects with esophagitis were classified as having grade A o r B (proportion of grades A and B; 9.6% and 4.6%, respectively). The age-re lated proportion of esophagitis and of severe esophagitis (i.e., grades C a nd D) increased in females aged over 70 and in males aged over 80. Increase d body mass index (partly due to decreased height caused by osteoporosis), and/or hiatal herniation, were related to the proportion of esophagitis in females aged over 70. These data indicated that reflux esophagitis is a com mon disease in Japan. However, severe esophagitis (grades C and D) is not c ommon.