Ethnic differences in gastro-oesophageal reflux disease

ABSTRACT

OBJECTIVES: To see whether the anecdotal statement that gastro-oesophageal reflux disease is less common in blacks than in white Caucasians is true. DESIGN: Study of the racial origin of adult patients who, at endoscopy, have oesophageal damage due to gastro-oesophageal reflux. SETTING: Gastroenterology unit of a teaching hospital in inner city in Birmingham, UK. MAIN OUTCOME MEASURE: Ethnicity and endoscopic grade of oesophageal damage (reflux oesophagitis) were recorded in every patient in whom oesophageal damage due to gastro-oesophageal reflux was diagnosed. RESULTS: Over the eight-year period 1989-1996, 1101 patients with endoscopically diagnosed grades I-V reflux oesophagitis have been seen, of whom 893 (81.9 percent) were white, 156 (14 percent) were Indian and 52 (5 percent) were Afro-Caribbeans. There were fewer patients with reflux oesophagitis from the two non-white ethnic groups than would be expected from their prevalence in the catchment population, and severe reflux oesophagitis was less common than expected in the two non-white groups. In all groups, patients with grades III, IV and V reflux oesophagitis were older than patients with grades I and II disease. Whites tended to be older than Afro-Caribbeans or Indians. CONCLUSION: There were fewer non-whites with reflux oesophagitis than would be expected but the reasons for this are unclear. This study has been useful as a pilot but further studies are needed in ethnically mixed non-migrant populations both in hospital, primary care and the community to clarify racial differences in reflux oesophagitis.(Au)