Clinical characteristics of reflux esophagitis among patients with liver cirrhosis: a case-control study

Scand J Gastroenterol. 2022 Apr;57(4):384-391. doi: 10.1080/00365521.2021.2018489. Epub 2021 Dec 29.

Abstract

Background: Reflux esophagitis (RE) can cause esophageal varices bleeding and largely reduce life quality of liver cirrhosis (LC) patients.

Aims: To clarify the prevalence, severity and risk factors of RE among LC patients.

Methods: A case-control study that enrolled 420 endoscopy-confirmed LC patients with RE as a case cohort and 409 LC patients without RE as a control group was conducted. Logistic regression was used to determine the risk factors for RE among LC patients.

Results: The 10-year cumulative incidence rate of RE was 4.79% among the LC patients. The severity of RE among the LC patients was higher than that among the non-LC patients (p<.05). The LC patients with RE patients were older (56 years vs. 53 years) and had higher rates of male patients (77.14% vs. 65.77%), smoking (46.90% vs. 32.76%), alcohol intake (50.24% vs. 41.08%), past endoscopic variceal ligation (EVL) (9.05% vs. 4.65%), endoscopic injection sclerotherapy (EIS) (16.19% vs. 2.69%), hiatus hernia (7.14% vs. 0.13%) and portal vein thrombosis (PVT) (14.05% vs. 4.01%). Logistic regression demonstrated that hiatus hernia, past EIS, PVT, smoking, white blood cell count, age, spleen thickness and platelet (PLT) count were risk factors for RE among the LC patients.

Conclusions: Patients with LC tended to have severer RE than non-LC patients. The special risk factors of RE among LC patients included past EIS and PVT, which deserved extra attention for hepatologists as well as gastroenterologists to prevent.

Keywords: Reflux esophagitis; endoscopic injection sclerotherapy; liver cirrhosis; portal vein thrombosis; risk factors.

MeSH terms

  • Case-Control Studies
  • Endoscopy, Gastrointestinal / adverse effects
  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / etiology
  • Esophagitis, Peptic* / complications
  • Esophagitis, Peptic* / epidemiology
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / prevention & control
  • Hernia, Hiatal* / complications
  • Humans
  • Ligation
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / epidemiology
  • Male
  • Sclerotherapy / adverse effects
  • Venous Thrombosis* / complications