건강검진자의 역류성 식도염에 대한 임상적 고찰

이선영(Sun Young Yi),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),한동수(Dong Soo Han),김정원(Jung Won Kim),민영일(Young Il Min) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Objectives: Gastroesophageal reflux disease (GERD) is used to describe any symptomatic clinical condition or histopathologic alteration resultant from episode of gastroesophageal reflux; reflux esophagitis describes a condition experienced by subset of GERD patients with histopathologically demonstrable changes in the esophageal mucosa. GERD is widely reported to be one of the most prevalent clinical condition affecting the gastrointestinal tract, the figures on its incidence and prevalence was not studied in Korea, Therefore we carried out this study to determine the prevalence of reflux esophagitis, in related with symptom, smoking, drugs, and overweight among general health screening people. Method: 2,795 cases which were visited at general health screening center of Asan medical center during 5 month-period from April, 1993 to August, 1993 were surveyed by esophagogastroscopy. We devided patients ioto reflux esophagitis by Savary-Miller stage. We assessed the prevalence of reflux esophagitis endoscopically and sex and age related prevalence, symptom, associated disease, smoking, drug, and overweight related esophagitis. Result: We expierenced 66 cases of reflux esophagitis in 2,795 cases examined (63 cases of stage I, 3 cases of stage II). Total age adjusted prevalence in 2.74% (95% CI 1.98~2.87). In sex-adjusted prevalence, male vs female prevalence is 32 to 1, so there was significantly higher prevalence of male than female. Asymptmatic reflux esophagitis case were 48 cases (72.7%). Having associated disease and ingested drug were not related with the prevalence of reflux esophagitis (p >0.05). Reflux esophagitis patients of smoking were significantly higher than non-smoking (p<0.01). Also, reflux esophagitis patients of overweight were significantly higher than ideal or underweight (p<0.001). Conclusion : Age adjusted prevalence of reflux esophagitis in general health screening people is speculated as 2.74%. And the most patient of reflux esophagitis is asymptomatic. The smoking and overweight have significantly related with reflux esophagitis.

위식도역류질환에서 십이지장위식도역류 - 장시간 보행성 식도내 pH및 빌리루빈의 동시측정에 의한 평가

최명규(Myong Gyu Choi),박수헌(Soo Heon Park),방춘상(Choon Sang Bang),한준열(Joon Yul Han),김재광(Jae Kwang Kim),최규용(Kyu Yong Choi),정인식(In Sik Chung),정규원(Kyu Won Chung),선희식(Hee Sik Sun),박두호(Doo Ho Park) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

N/A Background/Aims: Esophageal reflux damage may be produced by agents other than acid and the term alkaline esophagitis has been applied. Methods using esophageal pH monitoring to assess duodenogastroesophageal reflux have been suggested but gastric neutralization has made these methods difficult to prove conclusively. The purpose of this study were to investigate the role of duodenogastroesophageal reflux in gastroesophageal reflux disease(GERD) and to understand the relationship between pH and duodenogastroesophageal reflux. Methods: we performed simul- taneous esophageal pH and bilirubin rnonitoring(Bilitec 2000, Synetics) in 14 symptomatic patients with gastroesophageal reflux and 10 healthy controls. Abnormal gastroesophageal reflux was defined when the percent total time of pHC4 or bilirubin absorbance 0.14 exceeded the 95th percentile of the range obtained in healthy volunteers. Results: Abnormal gastroesophageal reflux was diagnosed in 12(85.7%) of 14 patients, who could be categorized into 3 acid refluxers, 1 bile refluxer or 8 combined acid and bile refluxers. All 6 patients with severe esophagitis(grade 2 by Savary Miller classification) were combined acid and bile refluxers and had markedly prolonged acid and bile reflux compared to 8 patients with normal or mild esophagitis(% total time of pH 4(mean+SE): 13.4+2.96 vs 5.0+1.8, p<0.05; % total time of bilirubin absorbance 0.14(mean+SE): 25.2+4.6% vs 7.9+3.8%, p<0.05). Mean pH of esophageal refluxate during bile reflux episode lasting longer than 5 minutes was 6.0(7.1% for pH C4, 8.8% for pH 4 5, 26.6% for pH 5-6, 47% for pH 6-7 and 8.3% for pH7). 4) 8 patients with a symptom index greater than 25% experienced 24 reflux symptoms of which 12(50.0%) were associated with acid reflux, 5(20.8%) were associated with bile reflux and 7(29.2%) were not associated with bile or acid reflux. Conclusions: Alkaline esophageal reflux is a misnomer. Esophageal pH monitoring does not adequately identify symptomatic non-acidic duodenogastroesophageal reflux. Patients with com- bined acid and bile reflux are more likely to develop severe esophagitis. (Korean J Gastroenterol 1996; 28:469 - 476)

천련자(川練子)가 만성 역류성 식도염 흰쥐에 미치는 효과

이진아 ( Jin A Lee ),신미래 ( Mi-rae Shin ),최정원 ( Jeong Won Choi ),노성수 ( Seong-soo Roh ) 대한본초학회 2021 大韓本草學會誌 Vol.36 No.3

Objective : Reflux esophagitis (RE), one of gastroesophageal reflux disease (GERD), is a disease that causes inflammation due to reflux of stomach contents such as stomach acid and pepsin due to the unstable gastroesophageal sphincter, and is currently increasing worldwide. The currently used treatment for reflux esophagitis has various side effects. Therefore, in this study the effect of Toosendan Fructus extract on chronic acid reflux esophagitis in rats was evaluated in order to find a new treatment material for reflux treatment. Methods : After inducing reflux esophagitis through surgery, the group was separated and the drug was administered for 2 weeks; Normal rats (Normal, n=8), chronic acid reflux esophagitis rats (Control, n=8), Toosendan Fructus 200 ㎎/㎏ body weight/day-treated chronic acid reflux esophagitis rats (TF, n=8). After, we were taken esophageal tissue and esophageal mucosa damage was identified, and analyzed the expression of NADPH oxidase, AP-1/MAPK-related proteins, and tight junction proteins by western blot in esophageal tissue. Results : Toosendan Fructus administration significantly protected the esophageal mucosal damage of reflux esophagitis. Also, Toosendan Fructus significantly reduced the expression of NADPH oxidases (NOX2 and p22^phox) and AP-1/MAPK-related proteins (c-Fos, c-Jun, p-p38, p-ERK, and p-JNK). In addition, it significantly increased the expression of tight junction proteins (Occludin, Claudin-3, and Claudin-4). Conclusions : These results suggest that Toosendan Fructus reduced damage to the esophageal mucosa by protecting the esophageal mucosa by upregulating tight junctions proteins as well as inhibiting the AP-1/MAPK pathway through reducing NADPH oxidases expression.

역류성 식도염으로 진단된 건강 검진자의 임상상

오정환 ( Jung Hwan Oh ),최명규 ( Myung Gyu Choi ),김혜랑 ( Hye Rang Kim ),박재명 ( Jae Myung Park ),백창렬 ( Chang Nyol Paik ),이준욱 ( Joon Wook Lee ),조유경 ( Yu Kyung Cho ),전은정 ( Eun Jung Jun ),정정조 ( Jeong Jo Jeong ),이 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.1

목적: 증상이 없는 역류성 식도염의 임상상은 잘 알려져 있지 않다. 연자들은 건강검진에서 내시경으로 진단된 미란성 식도염의 임상상을 조사하였다. 대상 및 방법: 2003년 8월부터 2005년 5월까지 건강 검진자 중 LA 분류 A이상의 역류성 식도염을 대상으로 하였다. 모든 대상자는 설문지를 작성하였다. 미란성 식도염의 임상특징과 위험인자를 조사하기 위해 미란성 식도염이 없는 건강 대조군과 비교하여 조사하였다. 결과: 미란성 식도염군 264명(남 201, 여 63, 평균나이 42.1±9.5), 정상 대조군 245명(남 146, 여 99, 평균나이 41.9±8.8이었다. 미란성 식도염을 가진 모든 수진자는 LA분류 A (85%), B (15%) 이었다. 미란성 식도염 군에서 주 1회 이상의 가슴쓰림은 10.6% (95% 신뢰구간 6.8-14.4), 주 1회 이상의 위산역류는 13.3% (95% 신뢰구간 9.1-17.4) 이었다. 미란성 식도염 군에서 가슴쓰림의 빈도는 건강 대조군과 차이가 없었다. 미란성 식도염 군의 80%에서는 1주일에 1번 이상의 전형적인 증상이 없었다. 다변량 분석으로 흡연력(하루에 담배 피우는 양)(교차비, 2.8; 95% 신뢰구간 1.7-4.4), 과 비만도(교차비, 1.2; 95% 신뢰구간, 1.1-1.3)가 미란성 식도염과 상관관계가 있었다. 역류성 식도염 군에서 정신신체 증상 점수는 증상이 있는 경우가 무증상인 경우보다 높았다. 결론: 미란성 식도염으로 진단된 건강 검진자의 20%만 뚜렷한 역류증상을 가지고 있었다. 증상이 있는 미란성 식도염을 가진 검진자가 높은 정신 신체 증상 점수를 가진다. 담배, 높은 체질량 지수가 미란성 식도염을 일으키는 위험 인자이다. Background/Aims: As little is known about asymptomatic patients with erosive reflux esophagitis, this study aimed to evaluate the characteristics of subjects with erosive reflux esophagitis who were diagnosed by endoscopy in a routine health check-up program. Methods: We prospectively recruited the subjects who had erosive reflux esophagitis (≥LA grade A) among those who visited a health promotion center for routine check-up. We performed a case-control study to evaluate the clinical characteristics and risk factors of reflux esophagitis. Results: The enrolled study participants comprised 264 subjects with erosive reflux esophagitis and 245 healthy controls. All subjects with erosive esophagitis had LA grade A (85%) or B (15%). Eighty percent of all subjects (N=264) with erosive esophagitis did not have frequent reflux symptoms. Using a multiple logistic regression analysis, erosive reflux esophagitis was associated with smoking (odds ratio (OR), 2.8; 95% confidence interval (CI), 1.7-4.4), and BMI (OR, 1.2; 95% CI, 1.1-1.3). Subjects with symptomatic erosive esophagitis had higher psychosomatic symptom scores than asymptomatic subjects did. Conclusions: Only 20% of subjects who were diagnosed with erosive esophagitis at their routine check-up had frequent reflux symptoms. Symptomatic erosive esophagitis was associated with psychological factor. (Kor J Neurogastroenterol Motil 2006;12:12-18)

Helicobacter pylori Serology Inversely Correlated With the Risk and Severity of Reflux Esophagitis in Helicobacter pylori Endemic Area: A Matched Case-Control Study of 5,616 Health Check-Up Koreans

정수진,임선희,최정민,김동희,김영선,박민정,임정윤,김주성,조상헌,정현채,송인성 대한소화기 기능성질환∙운동학회 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.3

Background/Aims The role of Helicobacter pylori in gastroesophageal reflux disease remains still controversial and the effect of the organism on severity of reflux esophagitis have been rarely issued. The aim of this study was to investigate the relationship between H. pylori infection and reflux esophagitis, and especially the severity of reflux esophagitis. Methods We performed a cross-sectional case-control study of 5,616 subjects undergoing both upper endoscopy and H. pylori serology during health Check-up (2,808 cases vs age- and sex-matched controls). Smoking, alcohol, body mass index and waist circumference were added to a multiple regression model. Results Prevalence of H. pylori infection was lower in cases with reflux esophagitis than in controls (38.4% vs 58.2%, P < 0.001) and negative associations with H. pylori infection continued across the grade of esophagitis (46.7% in Los Angeles classification M [LA-M], 34.3% in LA-A or LA-B and 22.4% in LA-C or LA-D, P < 0.001). Positive serology for H. pylori independently reduced the risk of reflux esophagitis (adjusted OR, 0.44; 95% CI, 0.39-0.49). Notably, the negative associations continued across the grade of esophagitis with adjusted ORs of 0.63 in LA-M, 0.36 in LA-A or LA-B and 0.20 in LA-C or LA-D (P < 0.001). Conclusions In a age-sex matched Korean, H. pylori seropositivity was independently and inversely associated with the risk and severity of reflux esophagitis, suggesting the organism may have a protective role against gastroesophageal reflux disease. (J Neurogastroenterol Motil 2011;17:267-273)

Helicobacter pylori Serology Inversely Correlated With the Risk and Severity of Reflux Esophagitis in Helicobacter pylori Endemic Area: A Matched Case-Control Study of 5,616 Health Check-Up Koreans

( Su Jin Chung ),( Seon Hee Lim ),( Jeong Min Choi ),( Dong Hee Kim ),( Young Sun Kim ),( Min Jeong Park ),( Jeong Yoon Yim ),( Joo Sung Kim ),( Sang Heon Cho ),( Hyun Chae Jung ),( In Sung Song ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.3

Background/Aims The role of Helicobacter pylori in gastroesophageal reflux disease remains still controversial and the effect of the organism on severity of reflux esophagitis have been rarely issued. The aim of this study was to investigate the relationship between H. pylori infection and reflux esophagitis, and especially the severity of reflux esophagitis. Methods We performed a cross-sectional case-control study of 5,616 subjects undergoing both upper endoscopy and H. pylori serology during health Check-up (2,808 cases vs age- and sex-matched controls). Smoking, alcohol, body mass index and waist circum - ference were added to a multiple regression model. Results Prevalence of H. pylori infection was lower in cases with reflux esophagitis than in controls (38.4% vs 58.2%, P < 0.001) and negative associations with H. pylori infection continued across the grade of esophagitis (46.7% in Los Angeles classification M [LA-M], 34.3% in LA-A or LA-B and 22.4% in LA-C or LA-D, P < 0.001). Positive serology for H. pylori independently reduced the risk of reflux esophagitis (adjusted OR, 0.44; 95% CI, 0.39-0.49). Notably, the negative associations continued across the grade of esophagitis with adjusted ORs of 0.63 in LA-M, 0.36 in LA-A or LA-B and 0.20 in LA-C or LA-D (P < 0.001). Conclusions In a age-sex matched Korean, H. pylori seropositivity was independently and inversely associated with the risk and severity of reflux esophagitis, suggesting the organism may have a protective role against gastroesophageal reflux disease.

역류성 식도염에서 Helicobacter Pylori 감염의 역할

정혜경,손혜영,김영선,이선영 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.3

연구 목적 : H. pylori는 만성 위염, 소화성 궤양, 위선암 등 다양항 위장관 질환과 연관된다고 알려져 있다. 그러나 역류성 식도염에서 그 역활에 대해서는 아직 이견의 여지가 많다, 최근 십이지장 궤양 환자에서 H. pyloni제균 치료 후 역류성 식도염이 증가하였다는 보고가 있는데, 이는 H. pylori 감염이 체부 위염으로 인해 위산 분비능력을 저하시켜 역류성 식도염 발생을 저하시키리라고 추측되었다. 그러므로 역류성 식도염, H. pylori 감염 및 체부 위염간의 연관성에 대해 알아보고자 본 연구를 고안하였다. 방법 : 1998년 3월부터 9월까지 위내시경상 Savary-Millard 등급 1이상인 역류성 식도염 환자 48명을 대상으로 하였다. 대조군은 종합검진 수진자 중 위식도 역류 증상이 없으며 내시경상 정상 소견을 보인 40예였다. 환자 및 대조군에서 위전정부 생검을 실시하여 rapid urease 검사 및 병리 조직학적 검사를 시행하였다. 결과 : H. pylori 감염률은 역류성 식도염 환자군 48예 중 21예(43.8%)에서, 대조군 40예 중 27예(67.5%)에서 양성을 보여 양 군간에 유의한 차이를 보였다.(p<0.05). 위체부 위염은 역류성 식도염 35예 중 29예에서 양성을 보였고 대조군에서는 15예 중 12예에서 양성을 보여 양 군간에 유의한 차이가 없었다. 또한 역류성 식도염 환자 중 체부 위염과 H. pylori 감염간에 유의한 상관관계가 없었다. 결론 : 위내시경으로 진단된 역류성 식도염 환자에서 H. pylori 감염률은 대조군에 비해 유의하게 낮았다. 역류성 식도염, 체부 위염 및 H. pylori 간에는 유의한 상관관계가 없었으나 병리학적 객관적 진단 기준의 미비로 단언하기 어렵다. 결론적으로 일부 환자에서 H. pylori 감염이 역류성 식도염 발생에 위험도를 저하시킬 수 있으며 그 기전에 관해서는 추후 연구가 필요하리라 생각된다. Objectives : Helicobacter pylory causes chronic gastritis, which progress to peptic ulcer, gastric atrophy, or gastric cancer. However, little is known about the role of Helicobacter pylori in reflux esophagitis. Corpus gastritis reduces the parietal cell mass and decreased peak acid output as a known risk factor for reflux esophagitis. So the relationship among reflux esophagitis and corpus gastritis and Helicobacter pylori needs to be clarified. Methods : In prospective, controlled study of patients with reflux esophagitis without other gastrointestinal disease, the prevalence of Helicobacter pylori was assessed. Antral and corpus biopsy were performed and rapid urease test and Giemsa staining were taken for Helicobacter pylori status. Results : The prevalence of Helicobacter pylori was 43.8%(21/48) in reflux esophagitis and 67.5%(27/40) in reference group. The prevalence of Helicobacter pylori was significantly lower in patients compared with the reference group(p<O.O5). The corpus gastritis was no significant relationship with reflux esophagitis and Helicobacter pylory. Conclusions : The prevalence of Helicobacter pylori infection in patients with reflux esophagitis is significantly lower than in the reference group, irrespective of corpus gastritis. It is suggested that Helicobacter pylori infection have a preventive role to reflux esophagitis, so we may be aware of balance between 'deleterious' and 'beneficial' effects of Helicobacter pylori eradication.

역류성 식도염 환자에서 증상 발현의 의미

한찬희(Chan Hee Han),이준성(Joon Seong Lee),임희혁(Hee Hyuk Lim),오영수(Young Soo Oh),윤영근(Young Keun Yoon),김상균(Sang Gyune Kim),김명수(Myung Soo Kim),류은상(Eun Sang Ryoo),윤동진(Dong Jin Youn),정인섭(In Seop Jung),고봉민(Bong M 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2

N/A Background/Aims : The relationship between the symptoms and severity of GERD may be difficult to prove. The intensity and frequency of reflux induced symptoms are poor predictors of the presence or severity of an endoscopic mucosal break. The aim of this study was to determine which factors can be predicted by the presence of GERD symptoms among esophageal sensitivity to acid, abnormal acid reflux, and severity of esophagitis in pateints with reflux esophagitis. Methods : Fourty-four patients who were diagnosed with reflux esophagitis by an endoscopy at a tertiary medical facility, were given a validated questionnaire, and underwent an acid perfusion test, 24 hr ambulatory esophageal pH monitoring, and esophageal manometry. These patients were divided into a symptomatic group and asymptomatic group according to the questionaire. Comparisons between the two groups for each factor were analyzed by Chi-square. Result : Of 44 patients, 26 had symptoms and 18 did not. The positive and equivocal rates of the acid perfusion test were not different between the symptomatic and asymptomatic groups (47% vs. 39%). The abnormal reflux rate (DeMeester score >14.72) from pH monitoring was significantly higher in the symptomatic group than in the asymptomatic group (65% vs. 28%, p <0.05). The severity of esophagitis, presence of a hiatal hernia, and abnormal esophageal manometric findings were not different between the two groups. Conclusion : It would be impossible to predict esophageal sensitivity to acid, severity of the esophagitis grade, and the presence of hiatal hernia with GERD symptoms, but it could be possible to predict abnormal gastroesophageal reflux.

Irritable Bowel Syndrome Is Associated With Gastroesophageal Reflux Symptom but Not Erosive Esophagitis

( Su Youn Nam ),( Kum Hei Ryu ),( Bum Joon Park ) 대한소화기기능성질환·운동학회 2013 Journal of Neurogastroenterology and Motility (JNM Vol.19 No.4

Background/Aims Although several studies have suggested overlaps between gastroesophageal reflux symptom and irritable bowel syndrome (IBS), the studies for the association between erosive esophagitis and IBS are rare. The aim of this study was to evaluate the association among IBS, non-erosive reflux disease (NERD), and erosive esophagitis. Methods A total of 2,769 participants completed questionnaires and underwent esophagogastroduodenoscopy and colonoscopy. IBS was diagnosed by Rome III; NERD was defined as heartburn or acid regurgitation occurring at least once per week without erosive esophagitis. Erosive esophagitis was defined by Los Angeles classification. Psychological distress was evaluated with modified 4 dimensions from revised Hopkins symptom checklist 90. Results Psychological distress was associated with both IBS and NERD, but not with erosive esophagitis. IBS was associated with somatization (adjusted OR, 2.88; 95% CI, 1.55-5.36; P < 0.001), anxiety (adjusted OR, 2.82; 95% CI, 1.36-5.88; P = 0.005), and hostility (adjusted OR, 2.06; 95% CI, 1.10-3.87; P = 0.024) and NERD was associated with somatization (adjusted OR, 5.65; 95% CI, 2.92-10.98; P < 0.001) and anxiety (adjusted OR, 3.29; 95% CI, 1.47-7.34; P = 0.004). Erosive esophagitis was associated with somatization (adjusted OR, 2.69; 95% CI, 1.26-7.91; P < 0.001). Hiatal hernia and male sex were related with erosive esophagitis but not with IBS or NERD. H. pylori had an inverse relationship with erosive esophagitis, but had no association with IBS. Whereas IBS was positively associated with NERD (adjusted OR, 2.72; 95% CI, 1.84-4.03; P < 0.001), it had no association with erosive esophagitis. Conclusions IBS shared many risk factors with NERD but not with erosive esophagitis. It partially explains why IBS was associated with NERD, but not with erosive esophagitis. (J Neurogastroenterol Motil 2013;19:521-531)

춘천 지역의 위식도 역류질환과 역류성 식도염의 특징 -건강 검진자 연구-

이주용 ( Jue Yong Lee ),홍원기 ( Won Ki Hong ),손경민 ( Kyung Min Sohn ),김대용 ( Dae Yong Kim ),김영묵 ( Young Mook Kim ),최현희 ( Hyun Hee Choi ),최창순 ( Chang Soon Choi ),김성중 ( Seong Jung Kim ),백광호 ( Gwang Ho Baik ),김 대한내과학회 2008 대한내과학회지 Vol.74 No.4

목적: 춘천을 중심으로 강원도 북서 지역의 건강 검진자를 대상으로 하여 위식도 역류 증상의 종류별 빈도와 역류식도염, 내시경적으로 의심되는 바렛 식도의 빈도를 알아보고자 하였다. 증상의 종류별로, 내시경적 역류식도염의 유무로 분류하여 각각에서 바렛 식도, 위궤양, 십이지장궤양, 식도 열공, 흡연 및 음주 등의 생활 습관의 차이가 있는지 연구하였다. 방법: 2005년 7월 1일부터 2006년 6월 30일까지 내시경을 포함한 건강검진을 받은 총 1,011명을 연구대상으로 하였다. 설문지를 통하여 증상, 흡연, 음주, 성별, 나이, 과거 HP 치료력을 얻었으며 내시경을 통해 역류식도염, 바렛 식도, 위궤양, 십이지장궤양, 식도 열공 등을 관찰하였다. 증상 종류별로 전형적 증상군, 비전형적 증상군, 증상이 없는 무증상군과 증상의 빈도가 낮아 불편감 없는 군으로 분류하였고, 내시경적 역류식도염의 유무로 분류하여 각 군 간의 임상적 차이를 알아보았다. 결과: 춘천을 중심으로 강원 북서 지역에서 건강 검진자중, 일상 생활에 지장을 주는 정도의 가슴 쓰림과 위산 역류의 증상을 호소하는 경우는 7.5%였으며 내시경적으로 역류 식도염은 9.7%에서 관찰되었다. 바렛 식도는 6.8%에서 내시경적으로 의심되었다. 증상의 유무에 따라 내시경적 역류식도염의 유병률에 통계적 차이를 나타냈으며 성별에 의한 뚜렷한 차이를 관찰할 수 있었다. 내시경적 역류식도염의 성별에 의한 차이가 2.8:1로 남자에서 많은 것으로 관찰되었으며 이와 함께 식도 열공과 음주, 흡연, 기침도 남자에게서 보다 빈번했으며 가슴 쓰림, 속 쓰림, 기타 증상은 여자에게서 빈번히 나타났다. 결론: 증상이 있는 군에서 증상 종류에 따라 연구에 포함된 모든 항목에서 통계적인 차이가 없었고, 증상의 정도 및 빈도는 내시경적 역류식도염과 연관성이 없었다. 그러나 증상의 유무와 역류식도염과는 연관성이 있었다. 이번 연구로 춘천을 중심으로 한 강원 북서 지역의 위식도 역류병의 일면을 보았고 향후 일반 인구집단에 대한 위식도 역류병의 유병률 조사가 필요하겠다. 내시경적 역류식도염에서 지역적 유병률의 차이, 관찰자간 차이 및 실제적 증가가 있는지에 대한 연구가 필요할 것으로 보인다. Background/Aims: The aims of this study were to estimate the frequency of symptoms of gastroesophageal reflux disease and reflux esophagitis, to evaluate the difference in characteristics among groups subdivided by symptoms, and to compare clinical features between a reflux esophagitis group and a non-reflux esophagitis group in Chuncheon City. Methods: A total of 1,011 persons who underwent endoscopy for health check-up were enrolled between July 1, 2005, and June 30, 2006. All persons were given a validated, self-reported questionnaire, which inquired about the presence, frequency, and severity of typical symptoms (heartburn and acid regurgitation) and atypical symptoms. The questionnaire also inquired about smoking, alcohol intake, and Helicobacter pyroli eradication. The subjects were subdivided into typical symptomatic, atypical symptomatic, no discomfort, and asymptomatic groups. Results: The prevalence of heartburn and acid regurgitation occurring at least weekly was 7.5%. Reflux esophagitis, hiatal hernia, smoking, and alcohol intake were more common in males (p<0.05). Ninety-eight cases (9.7%) were endoscopically diagnosed as reflux esophagitis, and sixty-nine cases (6.8%) were endoscopically suspected esophageal metaplasia (ESEM). Subjects in the symptomatic group more frequently manifested reflux esophagitis than subjects in the asymptomatic group (p<0.05). Conclusions: The presence of reflux-induced symptoms is related to reflux esophagitis, but the intensity and frequency of symptoms are poor predictors of the presence or severity of endoscopic mucosal breaks.(Korean J Med 74:385-390, 2008)