Will symptomatic gastroesophageal reflux disease develop into reflux esophagitis?

Background. The objective of this study was to ascertain whether symptomatic gastroesophageal reflux disease (SGERD) without endoscopic evidence of inflammatory findings would develop into esophagitis. Methods. Observation by endoscopic examination was conducted annually for 5 years, using as subjects 497 patients among those who underwent gastroesophageal endoscopy in their health examination, but patients with findings of esophagitis and those who had undergone Helicobacter pylori eradication therapy were excluded. Of the 497 subjects, 47 were found to belong to the SGERD group and the remaining 450 to the negative GERD group. Results. Hiatus hernia was observed in 31.9% of the SGERD group and 10.9% of the negative GERD group, with the rate being significantly higher in the SGERD group. Esophagitis developed in 36.2% of the SGERD group and in 11.3% of the negative GERD group. The risk of esophagitis was significant in the presence of SGERD (P < 0.01), the absence of H. pylori infection (P < 0.01), the absence of gastric mucosa atrophy (P < 0.01), elevated triglycerides during the 5-year follow-up (P < 0.05), and an elevated body mass index (P < 0.05). Thus, even following adjustment for other factors, SGERD, with a demonstrated hazard ratio of 3.07, was a significant risk of reflux esophagitis. Conclusions. The possibility is high that the presence of SGERD is a risk factor for esophagitis. In particular, individuals with hiatus hernia, those without H. pylori infection, and those who smoke and drink alcohol are prone to develop esophagitis.