Gastroesophageal reflux disease in an area with low Helicobacter pylori infection prevalence

The association between gastroesophageal reflux disease (GERD) prevalence and its risk
factors in an area with low Helicobacter pylori prevalence is important to clarify. We ana-
lyzed the prevalence of GERD and risk factors in an area of Indonesia with low prevalence
of H. pylori infection. We recruited 104 dyspeptic patients who underwent endoscopy in
Surabaya. Patients were diagnosed with GERD based on the Los Angeles classification.
We evaluated gastric biopsy specimens and measured serum pepsinogen levels. Interleu-
kin polymorphisms were evaluated by polymerase chain reaction-restriction fragment length
polymorphism. Of 104 patients, 56 (53.8%) were endoscopically found to have GERD, with
most categorized as grade A; 48 (46.2%) were classified as non-GERD. Higher economic
status, smoking, and a history of proton-pump inhibitor use significantly increased the risk of
GERD. GERD Questionnaire scores showed a positive correlation with GERD (P < 0.001).
An association was found between antral atrophic gastritis and GERD (P = 0.030), and
patients with GERD more frequently had severe antral atrophy than nonerosive reflux dis-
ease (P = 0.018). We found an association between pepsinogen I/II levels and GERD
(P = 0.047), but with low accuracy. IL-1β -511 TT and CT were predominant among the IL-
1β -511 genotypes, and IL-8–251 AT and TT were predominant among the IL-8–251 geno-
types. In conclusion, we found a high prevalence of GERD in an area with low prevalence of
H. pylori infection, which could be associated with acid reflux. Smoking, history of proton-
pump inhibitor use, and higher economic group significantly increased the risk of GERD.