Abstract
BackgroundAs illustrated by the Montreal classification, gastroesophageal reflux disease (GERD) is much more than heartburn and patients constitute a heterogeneous group. Understanding if links exist between patients’ characteristics and GERD symptoms, and classify subjects based on symptom-profile could help to better understand, diagnose, and treat GERD. The aim of this study was to identify distinct classes of GERD patients according to symptom profiles, using a specific statistical tool: Latent class analysis.MethodsAn observational single-visit study was conducted in 5 European countries in 7700 adults with typical symptoms. A latent class analysis was performed to identify “latent classes” and was applied to 12 indicator symptoms.ResultsOn 7434 subjects with non-missing indicators, latent class analysis yielded 5 latent classes. Class 1 grouped the highest severity of typical GERD symptoms during day and night, more digestive and non-digestive GERD symptoms, and bad sleep quality. Class 3 represented less frequent and less severe digestive and non-digestive GERD symptoms, and better sleep quality than in class 1. In class 2, only typical GERD symptoms at night occurred. Classes 4 and 5 represented daytime and nighttime regurgitation. In class 4, heartburn was also identified and more atypical digestive symptoms. Multinomial logistic regression showed that country, age, sex, smoking, alcohol use, low-fat diet, waist circumference, recent weight gain (>5 kg), elevated triglycerides, metabolic syndrome, and medical GERD treatment had a significant effect on latent classes.ConclusionLatent class analysis classified GERD patients based on symptom profiles which related to patients’ characteristics. Although further studies considering these proposed classes have to be conducted to determine the reproducibility of this classification, this new tool might contribute in better management and follow-up of patients with GERD.
Highlights
As illustrated by the Montreal classification, gastroesophageal reflux disease (GERD) is much more than heartburn and patients constitute a heterogeneous group
Gastroesophageal reflux disease (GERD) refers to reflux of the gastric content into the esophagus, leading to esophagitis, reflux symptoms impairing the quality of life, or long-term complications [1]
The purpose of this study was to try to identify distinct classes of adult subjects with respect to their different GERD symptoms by means of a latent class analysis (LCA), and to investigate if there is a relation between these latent classes and associated factors
Summary
As illustrated by the Montreal classification, gastroesophageal reflux disease (GERD) is much more than heartburn and patients constitute a heterogeneous group. Gastroesophageal reflux disease (GERD) refers to reflux of the gastric content into the esophagus, leading to esophagitis, reflux symptoms impairing the quality of life, or long-term complications [1]. Individuals with the typical GERD symptoms of heartburn and acid regurgitation constitute a heterogeneous group. The combinations of the different symptoms, their associations, and their link with clinical or demographic factors (age, body mass index [BMI], history of GERD, comorbidities, etc.), might be more prominent in certain groups of patients. An improvement in the understanding of the structure underlying these individual differences in GERD symptoms would help to individualize subject profiles and to adapt GERD management
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