Acid suppression therapy as a risk factor for Candida esophagitis

Dig Dis Sci. 2013 May;58(5):1282-6. doi: 10.1007/s10620-012-2520-x. Epub 2013 Jan 10.

Abstract

Background/aim: As the prevalence of reflux esophagitis increases, so does the use of gastric acid suppressants. This study aimed to document the prevalence of Candida esophagitis (CE) at a single Korean university hospital over the last 5 years and to evaluate its risk factors.

Methods: To investigate the prevalence of CE, we conducted a retrospective analysis of 55,314 individuals who underwent a screening esophagogastroduodenoscopy as part of a health check-up between January 2006 and December 2010 at Kyung Hee University Hospital in Seoul, Korea. A total of 250 patients who were treated for CE between January 2008 and August 2011 and 500 age- and sex-matched non-CE patients were enrolled in this study. The rates of recent gastric acid suppression therapy and other well-known risk factors in the two groups were compared.

Results: The prevalence of CE was 0.35 % and increased each year (linear-by-linear association, P = 0.001). Univariate analysis showed that gastric acid suppression therapy, malignancy, DM and steroid therapy were related to CE. Multivariate analysis also showed that gastric acid suppression therapy (OR 5.11, 95 % CI 2.92-8.93 and P < 0.001), malignancy (OR 18.68, 95 % CI 6.37-54.75 and P < 0.001), DM (OR 2.67, 95 % CI 1.70-4.21 and P < 0.001) and steroids therapy (OR 6.74, 95 % CI 1.37-33.05 and P = 0.019) were related to CE.

Conclusions: The prevalence of CE in Korea is increasing. Also, our results indicate that acid suppression therapy is a meaningful risk factor for CE.

MeSH terms

  • Aged
  • Candidiasis / chemically induced
  • Candidiasis / epidemiology*
  • Esophagitis / chemically induced
  • Esophagitis / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prevalence
  • Proton Pump Inhibitors / adverse effects*
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Proton Pump Inhibitors