Objective: To investigate the risk factors of reflux esophagitis (RE) in farmers of Shandong province.
Methods: Five hundred and fifty six peasants (aged from 34 to 90 years old) were randomly selected from the rural general population in Yantai area, Shandong province. All participants received a face to face interview for relating clinical symptoms. Upper gastrointestinal endoscopic and histopathologic examination were carried out.
Results: 101 (18.2%) patients were diagnosed endoscopically as RE. According to Los Angeles Classification system, the distribution of types was as follows: A: 36.6% (37/101), B: 56.4% (57/101), C: 3.0% (3/101), D: 4.0% (4/101). The gender (P < 0.001), age (P = 0.041), time engaged in farming (P = 0.040) of the subjects and the length from Z line to fore-tooth (P = 0.001) were correlated with the occurrence of RE. Smoking (OR 1.894, 95% CI 1.207 - 2.974), drinking strong tea (OR 2.900, 95% CI 1.651 - 5.092), using non-steroidal anti-inflammatory drugs (NSAIDs) (OR 2.159, 95% CI 1.166 - 3.997) and loose cardia (OR 13.630, 95% CI 7.37 - 25.19) were risk factors of RE. But there was no relationship between RE and the height, body weight, abdominal circumference, body mass index (BMI), alcohol drinking, special food habit and the history of diabetes, previous abdominal operation, peptic ulcer and atrophic gastritis of the subjects. H.pylori infection rate in the population was 51.3% (273/532). 37.1% (36/97) of RE patients and 54.5% (237/435) of non-RE patients were H.pylori positive (P = 0.002), OR 0.492 (95% CI 0.313 - 0.776).
Conclusions: Male gender, aging, shorter length from Z line to fore tooth, loose cardia and absence of H.pylori infection were correlated with RE. Smoking, drinking strong tea, NSAIDs and long time engaged in farming were risk factors of RE.