Risk factors and 26-years worldwide prevalence of endoscopic erosive esophagitis from 1997 to 2022: a meta-analysis

Andro Pramana Witarto, Bendix Samarta Witarto, Shidi Laras Pramudito, Lintang Cahyaning Ratri, Nabilah Azzah Putri Wairooy, Tiffany Konstantin, Achmad Januar Er Putra, Citrawati Dyah Kencono Wungu, Annisa Zahra Mufida, Arief Gusnanto

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2 Citations (Scopus)


Erosive esophagitis (EE) is the part of gastroesophageal reflux disease (GERD) spectrum and may progress to esophageal adenocarcinoma. Due to its progressivity and unclear prevalence, we aim to identify the factors contributing in EE to decide the need for further examination. We performed a PRISMA 2020-based systematic search through PubMed and other resources up to June 2, 2022. Study quality was assessed using the Newcastle–Ottawa Scale (NOS). The odds ratio (OR) of each factor and worldwide prevalence of EE were measured. There are 114 observational studies included with a total of 759,100 participants. Out of 29 factors, the significant risk factors are age ≥ 60 y.o. (OR 2.03 [1.81–2.28]), White/Caucasian (OR 1.67 [1.40–1.99]), unmarried (OR 1.08 [1.03–1.14]), having GERD ≥ 5 years (OR 1.27 [1.14–1.42]), general obesity (OR 1.78 [1.61–1.98]), central obesity (OR 1.29 [1.18–1.42]), diabetes mellitus (DM) (OR 1.24 [1.17–1.32]), hypertension (OR 1.16 [1.09–1.23]), dyslipidemia (OR 1.15 [1.06–1.24]), hypertriglyceridemia (OR 1.42 [1.29–1.57]), hiatal hernia (HH) (OR 4.07 [3.21–5.17]), and non-alcoholic fatty liver disease (NAFLD) (OR 1.26 [1.18–1.34]). However, H. pylori infection (OR 0.56 [0.48–0.66]) and atrophic gastritis (OR 0.51 [0.31–0.86]) are protective towards EE. This study demonstrates that age, ethnicity, unmarried, long-term GERD, metabolic diseases, HH, and NAFLD act as risk factors for EE, whereas H. pylori infection and atrophic gastritis act as protective factors. These findings may enable a better understanding of EE and increase greater awareness to address its growing burden.

Original languageEnglish
Article number15249
JournalScientific Reports
Issue number1
Publication statusPublished - Dec 2023


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