2851 Assessing the Risk of Gastroesophageal Reflux Disease in Patients With Constipation

Abstract

INTRODUCTION: Constipation is a common gastrointestinal disorder which can result in infrequent stools, difficult stool passage with pain and stiffness or both. Constipation is frequently associated with straining which also can promote GERD. Multiple comorbidities are reported in the literature secondary to chronic constipation but data on the presence of GERD in patients reporting constipation is limited. The aim of this study was to investigate if constipation increases the risk for gastroesophageal reflux disease (GERD) using a large patient database. METHODS: Using data from the National Inpatient Sample (NIS) database between 2004 and 2014, we identified patients who were diagnosed with constipation using appropriate ICD 9 coding. The control group were patients who did not have a diagnosis of constipation. Demographic information, tobacco use, hernia presence and GERD diagnosis was then compared between the 2 groups to determine if any association between constipation and GERD existed using univariate and multivariate logistic regression. RESULTS: The total population was comprised of 85,317,627 patients, of which 2,419,827 (2.8%) were diagnosed with constipation. Constipated patients were older (62 vs 48 yrs old) and more likely to be females (60.3% vs 58.2%) compared to non-constipated group (P < 0.01 for all). Constipated patients were more obese (9.1% vs 7.4%) , had more tobacco use (11.1% vs 10.1%) and had more diaphragm hernias (3% vs 1%) compared to the control group (P < 0.01 for all). Using Multivariate logistic regression, and after adjusting for age, gender, race, smoking, alcohol, diaphragmatic hernia and obesity, constipated patients had a statistically significant higher rate of GERD (Odds Ratio [OR], 1.599, 95% confidence interval [CI], 1.593 -1.605, P < 0.001) compared to the non-constipated control group. CONCLUSION: Constipation is associated with almost 60% increased risk of GERD. Screening for GERD and treating GERD, if present, is essential in the optimal management of constipated patients.