Wang Xiaoliang, Almetwali Omar, Wang Jiayan, Wright Zachary, Patton-Tackett Eva D, Roy Stephen, Tu Lei, Song Gengqing
Gastroenterology, Hepatology & Nutrition, Digestive Disease & Surgery Institute, Cleveland Clinic Main Campus, Cleveland, OH 44195, USA.
Joan C. Edwards School of Medicine, Marshall University Internal Medicine, Huntington, WV 25701, USA.
J Clin Med. 2024 Aug 14;13(16):4783. doi: 10.3390/jcm13164783.
: Although heartburn and reflux are frequently reported in ulcerative colitis [UC], the correlation between UC and gastroesophageal reflux disease [GERD], and its complications, esophageal stricture and Barrett's esophagus [BE], is not well understood. This study aims to examine the prevalence and associated risk of GERD and its complications within the UC population. : We analyzed the National Inpatient Sample (NIS) dataset, consisting of 7,159,694 patients, comparing GERD patients with and without UC to those without GERD. We assessed the degree of colonic involvement in UC and the occurrence of esophageal complications. Bivariate analyses were conducted using the chi-squared test or Fisher exact test (two-tailed). : A higher prevalence of GERD (23.0% vs. 16.5%) and GERD phenotypes, such as non-erosive reflux disease (NERD) (22.3% vs. 16%) and erosive esophagitis (EE) (1.2% vs. 0.6%), was found in UC patients ( < 0.01), including pancolitis, proctitis, proctosigmoiditis, left-sided colitis, and indetermined UC (with undefined colonic involvement). UC patients were more likely to develop GERD (1.421), NERD (1.407), and EE (1.681) ( < 0.01). A higher prevalence of esophageal stricture (16.9 vs. 11.4 per 10,000 patients) and BE without dysplasia (94.5 vs. 39.3 per 10,000 patients) was found in UC ( < 0.05). The odds of developing BE without dysplasia were higher (1.892) in patients with UC ( < 0.01), including ulcerative pancolitis, proctitis, and indeterminate UC (OR of 1.657, 3.328, and 1.996, respectively) ( < 0.05). : Our study demonstrates an increased risk of developing GERD and its complications in UC. This highlights the importance of vigilant monitoring and early intervention to minimize associated GERD-related risks in patients with UC.
尽管溃疡性结肠炎（UC）患者经常报告有烧心和反流症状，但UC与胃食管反流病（GERD）及其并发症（食管狭窄和巴雷特食管（BE））之间的关联尚未完全明确。本研究旨在调查UC患者中GERD及其并发症的患病率和相关风险。
我们分析了包含7159694名患者的全国住院患者样本（NIS）数据集，比较了患有和未患有UC的GERD患者与未患有GERD的患者。我们评估了UC患者结肠受累的程度以及食管并发症的发生情况。使用卡方检验或费舍尔精确检验（双侧）进行双变量分析。
在UC患者（包括全结肠炎、直肠炎、直肠乙状结肠炎、左侧结肠炎和未定型UC（结肠受累情况未明确））中，GERD的患病率更高（23.0%对16.5%），以及GERD表型，如非糜烂性反流病（NERD）（22.3%对16%）和糜烂性食管炎（EE）（1.2%对0.6%）（P<0.01）。UC患者更易发生GERD（比值比[OR]=1.421）、NERD（OR=1.407）和EE（OR=1.681）（P<0.01）。在UC患者中，食管狭窄的患病率更高（每10000名患者中16.9例对11.4例），无发育异常的BE患病率更高（每10000名患者中94.5例对39.3例）（P<0.05）。UC患者发生无发育异常的BE的几率更高（OR=1.892）（P<0.01），包括溃疡性全结肠炎、直肠炎和未定型UC患者（OR分别为1.657、3.328和1.996）（P<0.05）。
我们的研究表明，UC患者发生GERD及其并发症的风险增加。这凸显了在UC患者中进行密切监测和早期干预以将相关GERD风险降至最低的重要性。
