Lower esophagus in dyspeptic Iranian patients: a prospective study

J Gastroenterol Hepatol. 2003 Mar;18(3):315-21. doi: 10.1046/j.1440-1746.2003.02969.x.


Background: Gastroesophageal junction cancer has increased over time in Western countries. Gastroesophageal reflux disease (GERD) is considered to be a major risk factor. We prospectively studied the prevalence of clinical, histological and endoscopic GERD, and premalignant changes among dyspeptic Iranian patients referred for upper gastrointestinal endoscopy (UGIE).

Methods: Consenting patients referred for UGIE to our clinic were enrolled. Their symptoms were recorded, UGIE was conducted, and biopsies from all suspicious lesions and across the Z-line were taken.

Results: Of the 344 enrolled patients, 269 (135 women, 134 men; mean age: 41.6 years) were evaluated. One major GERD symptom (heart burn, acid regurgitation, dysphagia and chest pain) was seen in 209 (77.6%) patients, and 207 patients (76.1%) had endoscopic esophagitis. Thirteen patients (5%) had specialized intestinal metaplasia at the gastrointestinal junction (SIM-GEJ), and three had glandular dysplasia (two low-grade, one high-grade). No symptom could predict the presence of histological or endoscopic findings. Patients with dysplasia had more advanced degrees of endoscopic esophagitis.

Conclusion: Gastroesophageal reflux disease is common among Iranian patients referred for diagnostic endoscopy. The prevalence of SIM-GEJ among this population was comparable to that reported in Western countries.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aphasia / diagnosis
  • Aphasia / pathology*
  • Barrett Esophagus / diagnosis
  • Barrett Esophagus / etiology
  • Barrett Esophagus / pathology
  • Endoscopy, Gastrointestinal
  • Esophagitis / diagnosis
  • Esophagitis / etiology
  • Esophagitis / pathology
  • Esophagus / pathology*
  • Female
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / etiology
  • Gastroesophageal Reflux / pathology
  • Helicobacter pylori
  • Hernia, Hiatal / diagnosis
  • Hernia, Hiatal / etiology
  • Hernia, Hiatal / pathology
  • Humans
  • Iran
  • Male
  • Metaplasia / diagnosis
  • Metaplasia / etiology
  • Metaplasia / pathology
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Sex Factors
  • Statistics as Topic