Erosive esophagitis in the Philippines: A comparison between two time periods


Dr Stephen N Wong, Endoscopy Unit, University of Santo Tomas Hospital, España, Manila, Philippines. Email:


Background:  In Asia, the incidence of gastroesophageal reflux disease diagnosed through endoscopy has increased from 3–9% to 14–16% in the last decade. The aim of this study was to determine the prevalence of erosive esophagitis (EE) over a span of 10 years in a tertiary care facility in the Philippines.

Methods:  All patients diagnosed with EE from 1994 to 1997 (period A) and from 2000 to 2003 (period B) were included in the study. The modified Savary–Miller and Los Angeles classifications were used to grade EE for periods A and B, respectively.

Results:  A total of 15 981 upper endoscopies were evaluated for this study. There was no significant difference in the male: female ratio (period A 1.43:1 vs period B 1.25:1, P = 0.459) and in the mean age of patients with EE (period A 46.4 vs period B 47.5, P = 0.395). The prevalence of EE was significantly higher (P < 0.0001) in period B (6.3%) as compared to period A (2.9%). However, despite a higher prevalence, more patients had mild esophagitis in period B as compared to period A. Conversely, there were more patients with esophageal ulcers (18.6%vs 5.9%, P < 0.001), esophageal strictures (2.3%vs 0%, P = 0.003), and hiatal hernia (15.8%vs 7.5%, P = 0.001) in period A. The presence of concomitant Barrett’s esophagus was not significantly different between the two time periods (period A 3.2%vs period B 5%, P = 0.367).

Conclusions:  The prevalence of EE was higher in 2000–2003 than in 1994–1997, although the complications associated with the disease diminished. The prevalence of concomitant Barrett’s esophagus remained stable.