DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20191303

A study of the symptoms of gastro oesophageal reflux disease and the associated risk factors in a tertiary care centre

Santni Manickam, Ganesh Sethuraman, Jayachandran Kuppusamy

Abstract


Background: Gastro esophageal reflux disease is the commonest pathologies encountered by gastroenterologist in day to day practice. Longstanding and untreated gastro esophageal reflux disease can lead to many complications including adenocarcinoma. This study was conducted to evaluate the various symptoms and to analyze the lifestyle and dietary factors influencing gastro esophageal reflux disease which can be modified.

Methods: Hundred patients with gastro-esophageal reflux disease of age more than 18 years were enrolled in the study. Various patient details including demographic details, lifestyle information and symptomatology data were analyzed and compared with complications.

Results: Mean age of gastro esophageal reflux disease patients was 56.09±15.93 years. Gastro esophageal reflux disease is more prevalent in males than females. Gastro esophageal reflux disease is more frequent in BMI <25, greater number of co morbidities and in non-vegetarians.  Mean age of gastro esophageal reflux disease with complications was 67±11.53 years and without complications was 52.64±15.57 years. No strong association of smoking, alcohol, spicy foods, fried foods, citrus fruits, heavy meals, tea/coffee, aerated drinks, sleep disturbance and effect on work was identified in gastro esophageal reflux disease.

Conclusions: Classical symptoms of gastro esophageal reflux disease were not present in all the patients. Higher age of the patient infers higher risk of complications. Daily episodes of heartburn, regurgitation and retrosternal chest pain implies higher risk of complications. Presence of Helicobacter pylori in gastro esophageal reflux disease patients signify higher risk of complications.


Keywords


Adenocarcinoma, Gastro esophageal reflux, Heartburns, Regurgitation, Retrosternal chest pain

Full Text:

PDF

References


Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: A global evidence-based consensus. Am J Gastroenterol. 2006;101:1900-20.

Dent J, El-Serag HB, Wallander M, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005 May 1;54(5):710-7.

DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal refl ux disease. The practice parameters committee of the American College of Gastroenterology. Am J Gastroenterol. 1999;94:1434-42.

Nebel OT, Fornes MF, Castell DO. Symptomatic gastroesophageal refl ux: Incidence and precipitating factors. Am J Dig Dis. 1976;21:953-6.

A Gallup Organization National Survey: Heartburn Across America. Princeton: The Gallup Organization Inc., Princeton, NJ. 1988.

Locke 3rd GR, Talley NJ, Fett SL, Zinsmeister AR, Melton 3rd LJ. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterol. 1997 May 1;112(5):1448-56.

Sharma P, Wani S, Romero Y, Johnson D, Hamilton F. Racial and geographic issues in gastroesophageal reflux disease. Am J Gastroenterol. 2008;103:2669-80.

Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms. Am J Gastroenterol. 1998;93:1816-22.

Bhatia SJ, Reddy DN, Ghoshal UC, Jayanthi V, Abraham P, Choudhuri G, Broor SL, Ahuja V, Augustine P, Balakrishnan V, et al. Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2011 May 1;30(3):118.

Kim YS, Kim N, Kim GH. Sex and gender differences in gastroesophageal reflux disease. J Neurogastroenterol Motility. 2016 Oct;22(4):575.

Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA. Association Between Body Mass Index and Gastroesophageal Reflux Symptoms in Both Normal Weight and Overweight Women. New Eng J Med. 2006;354:2340-8.

Moraes-Filho JPP, Navarro-Rodriguez T, Eisig JN, Barbuti RC, Chinzon D, Quigley EMM. Comorbidities are Frequent in Patients with Gastroesophageal Reflux Disease in a Tertiary Health Care Hospital. Clinics (Sao Paulo, Brazil). 2009;64(8):785-790.

Kahrilas PJ. Regurgitation in Patients with Gastroesophageal Reflux Disease. Gastroenterol Hepatol. 2013;9(1):37-9.

Fujiwara Y, Machida A, Watanabe Y, Shiba M, Tominaga K, Watanabe T, et al. Association between dinner-to-bed time and gastro-esophageal reflux disease. Am J Gastroenterol. 2005 Dec;100(12):2633.

Çela L, Kraja B, Hoti K, Toçi E, Muja H, Roshi E, et al. Lifestyle characteristics and gastroesophageal reflux disease: a population-based study in Albania. Gastroenterol Res Practice. 2013;2013.

Myklebust S, Espelid I, Svalestad S, Tveit AB. Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits in 1990 and 1999. Acta Odontol Scand. 2003 Jan 1;61(2):100-4.

Iwakiri K, Kobayashi M, Kotoyori M, Yamada H, Sugiura T, Nakagawa Y. Relationship between postprandial esophageal acid exposure and meal volume and fat content. Dig Dis Sci. 1996 May 1;41(5):926-30.

Gross M, Beckenbauer U, Burkowitz J, Walther H, Brueggenjuergen B. Impact of gastro-oesophageal reflux disease on work productivity despite therapy with proton pump inhibitors in Germany. Eur J Med Res. 2010;15(3):124-30.

Jung H, Choung RS, Talley NJ. Gastroesophageal Reflux Disease and Sleep Disorders: Evidence for a Causal Link and Therapeutic Implications. J Neurogastroenterol Motility. 2010;16(1):22-29.

Labenz J, Blum AL, Bayerdorffer E, Meining A, Stolte M, Borsch G. Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterol. 1997 May 1;112(5):1442-7.

Malfertheiner P , Gerards C. Helicobacter pylori infection and gastro-oesophageal reflux disease: coincidence or association? Baillieres Best Pract Res Clin Gastroenterol. 2000;14:731-41.

Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999 Aug 1;45(2):172-80.

Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association medical position statement on the management of Barrett’s esophagus. Gastroenterol. 2011;140:1084-91.

Chait MM. Gastroesophageal reflux disease: Important considerations for the older patients. World J Gastrointestinal Endosc. 2010;2(12):388-96.

Chait MM. Complications of gastroesophageal reflux disease in the elderly. Ann Long Term Care. 2005;13:8-32.

Thrift AP, Kramer JR, Qureshi Z, Richardson PA, El-Serag HB. Age at Onset of GERD Symptoms Predicts Risk of Barrett’s Esophagus. Am J Gastroenterol. 2013;108(6):915-922.

Chait MM. The association and clinical implications of gastroesophageal reflux disease and H pylori. Practical Gastroenterology. 2006;30:40–48.

Farup C, Kleinman L, Sloan S, Ganoczy D, Chee E, Lee C, Revicki D. The impact of nocturnal symptoms associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med. 2001;161:45-52.

Mody R, Bolge SC, Kannan H, Fass R. Effects of gastroesophageal reflux disease on sleep and outcomes. Clin Gastroenterol Hepatol. 2009;7:953-9.

Sharma P. Recent advances in Barrett’s esophagus: short-segment Barrett’s esophagus and cardia intestinal metaplasia. Semin Gastrointest Dis. 1999;10:93-102.

Labenz J, Jaspersen D, Kulig M, Leodolter A, Lind T, Meyer-Sabellek W, et al. Risk factors for erosive esophagitis: a multivariate analysis based on the ProGERD study initiative. Am J Gastroenterol. 2004;99:1652-6.

Zhang J, Chen XL, Wang KM, Guo XD, Zuo AL, Gong J. Relationship of gastric Helicobacter pylori infection to Barrett’s esophagus and gastro-esophageal reflux disease in Chinese. World J Gastroenterol. 2004;10:672-5.

Ye W, Held M, Lagergren J, Engstrand L, Blot WJ, McLaughlin JK, Nyrén O. Helicobacter pylori infection and gastric atrophy: risk of adenocarcinoma and squamous-cell carcinoma of the esophagus and adenocarcinoma of the gastric cardia. J Natl Cancer Inst. 2004;96:388-96.

Ye W, Held M, Lagergren J, Engstrand L, Blot WJ, McLaughlin JK, et al. Helicobacter pylori infection andgastric atrophy: risk of adenocarcinoma and squamous-cell carcinoma of the esophagus and adenocarcinoma of the gastric cardia. J Natl Cancer Inst. 2004;96(5):387-96.