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

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.

Graphical Abstract

Keywords:

• Reflux esophagitis
• liver cirrhosis
• risk factors
• portal vein thrombosis
• endoscopic injection sclerotherapy

Acknowledgements

We thank nurse Li Zhang of the endoscopy lab of Beijing You’an Hospital for assisting in the collection of the endoscopy results of enrolled patients.

Author contributions

Zijin Liu and Lin Wei searched the literature and collected the data; Zijin Liu wrote the manuscript; and Huiguo Ding designed the project and edited the manuscript. All the authors have read and approved the manuscript.

Disclosure statement

There are no financial conflicts of interest to disclose.

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.