Gastroesophageal reflux among different racial groups in the United States

Hashem B. El-Serag, Nancy J. Petersen, Junaia Carter, David Y. Graham, Peter Richardson, Robert M. Genta, Linda Rabeneck

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Background & Aims: White people in the United States are several-fold more affected by esophageal adenocarcinoma than black people. It remains unknown whether this racial discrepancy reflects a higher prevalence of gastroesophageal reflux disease (GERD) symptoms or a higher degree of esophageal damage. Methods: A cross-sectional survey followed by endoscopy was performed among employees at a VA medical center. The association between race and GERD symptoms and erosive esophagitis was analyzed in logistic regression analyses controlling for demographic, clinical, and histologic variables. Results: A total of 496 of 915 people (54%) returned interpretable questionnaires, and endoscopy was performed in 215 participants. The mean age was 45 years, and 336 (68%) were women. Racial distribution was 43% black, 34% white, and 23% other races. Heartburn occurring at least weekly was reported in 27%, 23%, and 24% of these racial groups, respectively. The age-adjusted prevalence of heartburn or regurgitation was not significantly different among the groups. Erosive esophagitis was found in 50 of 215 participants (23%); 31 of these cases were mild. Only one person had Barrett's esophagus (0.4%). For weekly heartburn or regurgitation, black participants had significantly less frequent erosive esophagitis than white participants (24% vs. 50%; P = 0.03). With multiple adjustments, black participants had a persistently lower risk of esophagitis (adjusted odds ratio, 0.22-0.46; P < 0.001). Conclusions: White and black people in the United States have a similarly high prevalence of GERD symptoms. However, black people have a lower prevalence of esophagitis for the same frequency of GERD symptoms Barrett's esophagus was rare in this study, even among those with frequent symptoms.

Original languageEnglish (US)
Pages (from-to)1692-1699
Number of pages8
JournalGastroenterology
Volume126
Issue number7
DOIs
StatePublished - Jun 2004

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Esophagitis
Gastroesophageal Reflux
Heartburn
Barrett Esophagus
Endoscopy
Adenocarcinoma
Cross-Sectional Studies
Logistic Models
Odds Ratio
Regression Analysis
Demography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

El-Serag, H. B., Petersen, N. J., Carter, J., Graham, D. Y., Richardson, P., Genta, R. M., & Rabeneck, L. (2004). Gastroesophageal reflux among different racial groups in the United States. Gastroenterology, 126(7), 1692-1699. https://doi.org/10.1053/j.gastro.2004.03.077

Gastroesophageal reflux among different racial groups in the United States. / El-Serag, Hashem B.; Petersen, Nancy J.; Carter, Junaia; Graham, David Y.; Richardson, Peter; Genta, Robert M.; Rabeneck, Linda.

In: Gastroenterology, Vol. 126, No. 7, 06.2004, p. 1692-1699.

Research output: Contribution to journalArticle

El-Serag, HB, Petersen, NJ, Carter, J, Graham, DY, Richardson, P, Genta, RM & Rabeneck, L 2004, 'Gastroesophageal reflux among different racial groups in the United States', Gastroenterology, vol. 126, no. 7, pp. 1692-1699. https://doi.org/10.1053/j.gastro.2004.03.077
El-Serag HB, Petersen NJ, Carter J, Graham DY, Richardson P, Genta RM et al. Gastroesophageal reflux among different racial groups in the United States. Gastroenterology. 2004 Jun;126(7):1692-1699. https://doi.org/10.1053/j.gastro.2004.03.077
El-Serag, Hashem B. ; Petersen, Nancy J. ; Carter, Junaia ; Graham, David Y. ; Richardson, Peter ; Genta, Robert M. ; Rabeneck, Linda. / Gastroesophageal reflux among different racial groups in the United States. In: Gastroenterology. 2004 ; Vol. 126, No. 7. pp. 1692-1699.
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abstract = "Background & Aims: White people in the United States are several-fold more affected by esophageal adenocarcinoma than black people. It remains unknown whether this racial discrepancy reflects a higher prevalence of gastroesophageal reflux disease (GERD) symptoms or a higher degree of esophageal damage. Methods: A cross-sectional survey followed by endoscopy was performed among employees at a VA medical center. The association between race and GERD symptoms and erosive esophagitis was analyzed in logistic regression analyses controlling for demographic, clinical, and histologic variables. Results: A total of 496 of 915 people (54{\%}) returned interpretable questionnaires, and endoscopy was performed in 215 participants. The mean age was 45 years, and 336 (68{\%}) were women. Racial distribution was 43{\%} black, 34{\%} white, and 23{\%} other races. Heartburn occurring at least weekly was reported in 27{\%}, 23{\%}, and 24{\%} of these racial groups, respectively. The age-adjusted prevalence of heartburn or regurgitation was not significantly different among the groups. Erosive esophagitis was found in 50 of 215 participants (23{\%}); 31 of these cases were mild. Only one person had Barrett's esophagus (0.4{\%}). For weekly heartburn or regurgitation, black participants had significantly less frequent erosive esophagitis than white participants (24{\%} vs. 50{\%}; P = 0.03). With multiple adjustments, black participants had a persistently lower risk of esophagitis (adjusted odds ratio, 0.22-0.46; P < 0.001). Conclusions: White and black people in the United States have a similarly high prevalence of GERD symptoms. However, black people have a lower prevalence of esophagitis for the same frequency of GERD symptoms Barrett's esophagus was rare in this study, even among those with frequent symptoms.",
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