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Higher Incidence of Erosive Reflux Disease in ICU Patients Than in Regular Floor Patients

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Han, Yoosun, M.D.; Barrie, Mahmoud, M.D.; Rosenberg, Marc D., M.D.; Cai, Qiang, M.D.

American Journal of Gastroenterology: September 2005 - Volume 100 - Issue - p S33–S34
Supplement Abstracts Submitted for the 70th Annual Scientific Meeting of the American College of Gastroenterology: ESOPHAGUS
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Medicine, Emory University School of Medicine, Atlanta, GA.

Purpose: Gastroesophageal reflux disease (GERD) is a very common disease that affects 20–50% of adults in Western Countries. The disease can be divided into three clinical categories: nonerosive reflux disease (NERD), erosive reflux disease (ERD), and Barrett's esophagus. Why do some patients with GERD have NERD and others have ERD? We do not have the answer for this question at the present time. The aim of this study is to determine risk factors for ERD.

Methods: We tallied all in-hospital esophgogastrodeudenoscopy (EGD) with diagnosis of ERD in the year of 2004. We reviewed all patients information regarding patient' age, gender, prior history of GERD, general healthy conditions, dietary history, etc to find the potential risks for ERD.

Results: In 2004, we had 455 in-patients EGD. ERD was reported in 21 patients (excluded other than reflux esophagitis, such as candidasis, pill esophagitis, etc.). Among the 455 patients, 165 were Intensive Care Unit (ICU) patients, the rest of 290 patients were in the regular floor. 16 patients in the ICU group had ERD; only 5 in the regular floor group had ERD. Therefore, the rate of ERD in this in-patient population was 4.6%(21/455), with 9.7%(16/165) and 1.7%(5/290) in the ICU patients and floor patients respectively. ICU patients had higher incidence of ERD than regular floor patients, even though ICU patients received histamine 2-receptor inhibitors more than the regular floor patients. Other factors, such as age, gender, history of GERD, etc. were not associated factors for ERD.

Conclusions: ICU patients are prone to have ERD despite receiving intravenously histamine 2-receptor inhibitors. Proton pump inhibitor prophylaxis may be better for those patients to prevent ERD.

© The American College of Gastroenterology 2005. All Rights Reserved.