Association between Gastroesophageal Flap Valve and Erosive Esophagitis

Objectives: Gastroesophageal flap valve (GEFV) can be divided into a four-grade system and this system can well predict the prevalence of gastroesophageal reflux disease (GERD). We tried to use this GEFV grading system to examine the correlation of GEFV to erosive esophagitis. Methods: We enrolled 398 individuals that underwent one-day self-paid health examination, including esoph agogastroduodenoscopy (EGD) in 3-month period. GEFV grade I and Ⅱ were considered normal, whereas grade Ⅲ and Ⅳ were abnormal. We compared and analyzed the correlation of sex, body mass index (BMI) and GEFV grading with erosive esophagitis. Results: There were 37 subjects being diagnosed as abnormal gastroesophageal flap valve (37/398, 9.3%). 18 of them (18/37, 48.6%) had erosive esophagitis also. The remaining 361 subjects were diagnosed as normal flap valve (361/398, 90.7%) and 53 subjects were diagnosed as erosive esophagitis (53/361, 14.7%). Abnormal gastroesophageal flap valve subjects had higher chance to had erosive esophagitis (Odds Ratio=7.51, 95% CI=3.53-15.98). Males had higher prevalence of erosive esophagitis (Odds Ratio=3.74, 95% CI=1.90-7.38) and the prevalence of erosive esophagitis was 17.8%. Age and BMI did not increase the risk of esophagitis remarkably in the initial analyses (P=0.15 and 0.2) Conclusion: Male gender and subject, who have abnormal gastroesophageal flap valve, are prone to develop erosive esophagitis. Age and BMI do not increase the risk of esophagitis remarkably.