# Erosive Esophagitis Unveiled: A Retrospective Study of Epidemiology and Endoscopic Findings in Qassim, Saudi Arabia

## TL;DR

This study found that erosive esophagitis affects 12.3% of endoscopy patients in Qassim, Saudi Arabia, with obesity and hiatal hernia being key risk factors.

## Contribution

The study provides new insights into the local prevalence and risk factors of erosive esophagitis in Saudi Arabia.

## Key findings

- Erosive esophagitis prevalence was 12.3% among endoscopy patients in Qassim.
- Obesity and hiatal hernia were strong independent predictors of erosive esophagitis.
- Most erosive esophagitis cases were mild (LA grade A).

## Abstract

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal condition caused by the reflux of gastric contents into the esophagus. Untreated GERD can lead to complications, including erosive esophagitis (EE), Barrett’s esophagus, and esophageal stricture. This study aimed to determine the prevalence of EE among patients undergoing endoscopy in Qassim, Saudi Arabia, and to identify associated risk factors.

Methods: We conducted a retrospective study at Habib Medical Group Hospital in Qassim, Saudi Arabia, including adult patients (≥18 years) who underwent upper gastrointestinal endoscopy between July 2021 and August 2022. Data were collected from electronic health records and included demographic information, body mass index (BMI), clinical presentation, endoscopy indication, and EE severity according to the Los Angeles (LA) classification. Associations between EE and potential predictors were assessed using chi-square testing and multivariate logistic regression. A p-value <0.05 was considered statistically significant. Data were analyzed using SPSS version 26 (IBM Corp., Armonk, NY, USA).

Results: A total of 1,010 patients were included. The prevalence of EE was 12.3% (124 patients). Males accounted for 65.3% of EE cases (p < 0.001). The majority of EE cases were mild, with 97 (78.2%) classified as LA grade A and 17 (13.7%) as grade B. Multivariate analysis revealed that obesity was a strong independent predictor of EE, with an adjusted odds ratio (AOR) of 9.834 (95% CI: 2.525-38.304; p = 0.001). The presence of a hiatal hernia was also significantly associated with EE (AOR = 7.365; 95% CI: 1.898-28.582; p = 0.004). Male sex did not remain significant after adjustment (p = 0.069).

Conclusions: The prevalence of EE in this study population was 12.3%, with most cases categorized as mild (LA-A). Higher BMI and the presence of a hiatal hernia were independent and significant predictors of EE, whereas male sex was not independently associated. These findings highlight the importance of addressing modifiable risk factors such as obesity in the prevention and management of EE.