Barrett's Esophagus (BE) is considered to be one of the most important complications of GERD due to its strong association with adenocarcinoma. Epidemiologic studies have consistently reported that the prevalence of BE-associated adenocarcinoma was very rare in Asia, especially in Eastern Asia [1, 2]. In Western, a higher prevalence of GERD was found in the elders, smokers and patients with outlined abdominal fat [3]. Epidemiologic changes of GERD in Asia seem to be correlated with economic or environmental effects, nutritional changes, Helicobacter pylori infections, and the geographic and ethnic differences [2, 4]. Compared to Western peoples, the general low-fat diet of Asian, their smaller body mass index (BMI) and also their higher prevalence of Helicobacter pylori might be related with the lower prevalence of GERD [2].
Well-established risk factors for GERD in Asian populations included obesity and hiatus hernia (HH) [5]. Multivariate analyses showed that only age > 60 years and males were significantly associated with HH in GERD patients, however, none of them was associated with HH in non-reflux subjects [6]. The incidence of HH did not differ between men and women, mainly occurring in the age distribution of 40–60 years [5], however, this study showed individuals with RE were younger than those without RE in men. In our patients of long term GERD, BMI was normal, with short duration BMI often was greater than 24.0kg/m2. We also think the frequency and quantity of alcohol on drinking days all are associated with the severity of RE and the prevalence of BE. Frequent alcohol drinking has damage on esophageal mucosal, especially when limosis. Overweight or/and obesity, lipid and uric acid metabolism are the primary risk factors of hypertension. The association between hypertension and GERD was not reported. The patients’ characteristics, patients’ rights and the pathogenesis of influence factors should be taken into account. Age and male sex may be risk factors in Asia, but it requires large-scale clinical data support.
References
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