Introduction
The interplay of race and gender significantly influences the manifestation of Gastroesophageal Reflux Disease (GERD) symptoms following Helicobacter pylori (H. pylori) treatment. This multifaceted relationship, deeply rooted in biological, cultural, and socioeconomic factors, presents a complex medical challenge. Understanding these disparities is crucial for tailoring effective treatment strategies, ensuring equitable healthcare outcomes, and advancing personalized medicine in managing GERD symptoms in diverse populations post-H. pylori eradication
Aims & Methods
Our research, spanning 2009 to 2023, retrospectively analyzed patients treated for H. Pylori, ensuring a minimum one-year follow-up. We collected data encompassing comorbidities, insurance status, and socioeconomic factors, particularly targeting the emergence of GERD symptoms, Esophagitis, and duodenal ulcers, identified using CPT and ICD codes. Initially, we employed a Chi-square test of independence to evaluate the association between race and GERD symptoms. We conducted a post-hoc analysis with adjusted standardized residuals to delve deeper, pinpointing specific races with notably higher or lower GERD symptom frequencies than expected. We performed pairwise race comparisons via Chi-square tests, applying a Bonferroni correction for multiple comparisons.
Results
Between 2009 and 2023, 4,205 patients received H. Pylori treatment, with 3,329 qualifying for our study after excluding those lost to follow-up. The average age was 54.5 years, with 64% female (2,134) and 48% Caucasian (1,664). The Chi-square test revealed a significant association between Race and GERD symptoms (Chi sq stat:8.69 p-value <0.01). In-depth post-hoc pairwise comparisons showed that the Hispanic race had significantly higher rates of GERD symptoms when compared to other races Other races (p <0.01), White (p <0.01), Black (p <0.01), and Asian races (<0.01). Adjusted residual analysis further confirmed that the Hispanic race (5.54, p<0.023) showed a higher-than-expected number of GERD symptom cases. Among the Hispanic races, Patients with low socioeconomic status showed increased GERD symptoms (Chi. Sq: 7.65, P<0.01). Gender does not significantly impact GERD symptoms (Chi. sq: 0.831, P = 0.512)
Conclusion
Our study, analyzing data from 2009 to 2023 on patients treated for H. Pylori, underscores the significant influence of race and gender on GERD symptoms post-treatment. Notably, the Hispanic population exhibited a higher incidence of GERD symptoms compared to other races, with socioeconomic status further intensifying this trend. These findings highlight the need for more personalized, culturally sensitive approaches in healthcare, emphasizing the importance of considering race, gender, and socioeconomic factors in the treatment and management of GERD following H. Pylori eradication.
References
Lai Y, Shi H, Wang Z, Feng Y, Bao Y, Li Y, Li J, Wu A. Incidence trends and disparities in Helicobacter pylori related malignancy among US adults, 2000-2019. Front Public Health. 2022 Nov 28;10:1056157. doi: 10.3389/fpubh.2022.1056157. PMID: 36518580; PMCID: PMC9743990.