[Etiopathogenetic factors of esophagitis in patients with gastroesophageal reflux disease].

Unlabelled: Gastroesophageal reflux disease (GERD) is one of the most common disorders of the gastrointestinal tract. Reflux oesophagitis is observed in about 30-50% of GERD patients. Factors leading to development of mucosal damage remain still unclear. This study aimed at determinating of possible etiopathological factors in the development of oesophagitis in GERD patients.

Methods: 60 consecutive patients with erosive oesophagitis and 60 consecutive patients with reflux disorder were included in the study. All patients had been suffering from both at least two episodes of typical reflux symptoms in the last week and for a minimum of three months. The accurate history with a focus on life style was taken. The patients underwent mandatory endoscopy with the assessment of oesophagitis (according to Los Angeles classification), presence of hiatal hernia, macroscopical changes in upper GI tract and presence of Helicobacter pylori. Subsequently patients underwent 24-hour pH-monitoring and oesophageal clearance test.

Results: No significant differences were noticed in the mean age, sex, life style, disease's duration. In the patients with oesophagitis hiatal hernia was observed more frequently and the infection of H. pylori was less frequently observed. The results of pH-metry showed that the degree of esophagitis correlated only with the number of long-lasting reflux episodes, duration of the time with pH lower than 4.0 and esophageal clearance time.

Conclusions: In patients with GERD both hiatal hernia and prolonged esophageal clearance time increase number of long-lasting reflux episodes and in consequence lead to the damage of oesophageal mucosa.