Endoscopic treatment of gastroesophageal reflux disease: Effect of gender on clinical outcome

OBJECTIVE: Gender differences in gastroesophageal reflux disease have been reported. Higher frequency and severity of symptoms, lower esophageal acid exposure and lower incidence of reflux-related complications have been observed in women. The aim of this study was to determine whether there are any gender differences in clinical presentation, diagnostic evaluations and response to endoscopic therapy in patients with gastroesophageal reflux disease. MATERIAL METHODS: Patients with gastroesophageal reflux disease referred for endoscopic therapy were scored for typical (heartburn and regurgitation) and atypical (chest pain, cough, wheezing, and hoarseness) symptoms at baseline. Upper endoscopy, manometry and pH studies were performed for all patients. Endoscopic treatment consisted of placement of two to three sutures within 2 cm of the squamocolumnar junction. Reflux symptoms were re-scored after endoscopic treatment. RESULTS: Ninety-five patients (37 M, 58 F, mean age 51 years) were included in the analysis. Male and female patients at baseline reported similar severity of typical reflux symptoms as well as comparable prevalence of atypical symptoms. Manometric findings were also comparable between the genders. Endoscopic and ambulatory pH studies revealed a higher incidence of erosive esophagitis and a trend towards higher acid exposures in male patients. The response to endoscopic therapy was similar for men and women. CONCLUSIONS: Apart from a higher incidence of erosive esophagitis in male patients, no major differences were found in endoscopic, manometric, esophageal acid exposure studies and clinical response to endoscopic therapy between the genders.