Clinical spectrum and risk factors associated with asymptomatic erosive esophagitis as determined by Los Angeles classification: a cross-sectional study

Background: Gastro esophageal reflux disease (GERD) is a chronic and recurrent disease, and it varies in regions. However, to date, there are no reports available on clinical features and the risk factors for the asymptomatic reflux esophagitis in Nepalese adults. Methods: Data were gathered from 142 erosive patients who had undergone endoscopy at Bir Hospital, Kathmandu. Los Angeles classification was used to grade the severity of the disease. Patients were interviewed to find out the presence of various reflux symptoms. Results: Based on the Los Angeles classification, the severity of the disease assessed was; grade A 31.8% (31/142), grade B 39.4 % (56/142), grade C 33.8% (48/142), and grade D 4.9% (7/142). One hundred and twenty six (88.7%) subjects had reflux symptoms. Prevalence of asymptomatic esophagits was 16(11.3%). Age was independently linked to asymptomatic esophagitis (P<0.05), and the odd of being asymptomatic appeared lower in younger adults (P<0.05; OR: 0.118; CI: 0.014-.994). Conclusion: A low prevalence of asymptomatic reflux esophagits (RE) was seen. Most subjects experienced mild to moderate RE. Age remained an independent factors associated with reflux esophagitis, and the odd of being asymptomatic was lower in younger age.

背景：胃食管反流病（Gastro esophageal reflux disease, GERD）是一种慢性复发性疾病，存在地域差异。截至目前，尚无针对尼泊尔成年人无症状反流性食管炎的临床特征与危险因素的研究报道。
方法：本研究数据采集自尼泊尔加德满都比尔医院接受内镜检查的142名糜烂性食管炎患者。采用洛杉矶分类标准对疾病严重程度进行分级。通过访谈患者，采集各类反流相关症状的发生信息。
结果：依据洛杉矶分类标准，本次评估的疾病严重程度分布如下：A级占31.8%（31/142），B级占39.4%（56/142），C级占33.8%（48/142），D级占4.9%（7/142）。其中126例（88.7%）受试者存在反流症状。无症状食管炎的患病率为16例（11.3%）。年龄与无症状食管炎存在独立相关性（P<0.05），年轻成年人发生无症状反流性食管炎的风险更低（P<0.05；优势比OR：0.118；置信区间CI：0.014-0.994）。
结论：本研究中无症状反流性食管炎（RE）的患病率较低。多数受试者为轻至中度反流性食管炎。年龄仍是与反流性食管炎相关的独立危险因素，且年轻群体出现无症状表现的概率更低。