Gastro-oesophageal reflux disease symptom subtypes and endoscopy findings: a retrospective, cross-sectional study from Southwestern Nigeria
摘要
Gastro-oesophageal reflux disease (GORD) presents with either oesophageal or extra-oesophageal symptoms, or both. The association between symptom subtypes and upper gastrointestinal endoscopy (UGIE) findings has been rarely studied in Nigeria. Our study aimed to determine the pattern of symptom subtypes and UGIE abnormalities, as well as their association in patients with GORD symptoms in Nigeria.
MethodsA retrospective, cross-sectional study of UGIE findings in patients with GORD from two endoscopy suites in southwest Nigeria, conducted from January 2022 to December 2023. Symptoms were categorised as oesophageal-only (OO), extra-oesophageal only (EO), or oesophageal plus extra-oesophageal (O + E). Demographic and UGIE data were compared using ANOVA, Pearson’s chi-square, or Fisher’s exact tests using R software. Analyses were two-tailed, and statistical significance was set at p < 0.017.
ResultsThere were 411 patients, 180 (43.8%) of whom were male, with a mean age of 45.3 years. The most frequent symptoms were chest pain (131, 31.9%) and heartburn (97, 23.6%). Overall, 280 (68.1%) of them presented with EO, 99 (24.1%) with OO, and 32 (7.8%) with O + E symptoms. Patients with O + E were younger (mean age 37.7 years) than those with OO (44.6 years) or EO (46.4 years), p = 0.008. On UGIE, gastroduodenal erosions were seen in 250 (60.8%), GORD-associated oesophageal injury in 183 (44.5%), peptic ulcer in 43 (10.5%), candidal oesophagitis in 38 (9.3%), tumour in 6 (1.5%), and normal findings in 34 (8.3%). Only gastroduodenal erosions were associated with symptom subtype.
ConclusionMost patients with GORD presented with extra-oesophageal symptoms. While fewer than half had reflux-associated oesophageal injury, non-oesophageal lesions were present in the majority of patients, highlighting the importance of endoscopic evaluation in patients with GORD symptoms.