Determinants of Gastroesophageal Reflux Disease in Adults With a History of Childhood Gastroesophageal Reflux Disease

Abstract

We conducted a nested case-control study to examine the prevalence and risk factors for current gastroesophageal reflux disease (GERD) symptoms in young adults with a history of childhood GERD. We identified a cohort of individuals diagnosed with GERD in childhood during 1995-1996, and controls without childhood GERD. Patients with neurodevelopmental disorders, tracheoesophageal anomalies, or cystic fibrosis were excluded. A computer-assisted telephone interview was conducted during 2004-2005. We calculated the prevalence of GERD symptoms, and examined the potential determinants of symptoms in unadjusted and adjusted logistic regression analyses. A total of 113 cases completed the questionnaires (participation rate, 70.6%). The mean age of participants was 18 years, and their mean age at the time of childhood GERD diagnosis was 10 years. At least weekly heartburn or regurgitation was reported in 52 (46%) participants, 94% of whom were taking proton pump inhibitors, H2RA, or antacids. On the other hand, 33 controls were identified (44% participation rate) in whom weekly heartburn or regurgitation was reported in 30%. GERD was significantly more frequent in females using oral contraceptive pills (76.5%) as compared with females not on oral contraceptive pills (47.9%), or males (33.3%) (P = .008). Weight, height, nonsteroidal anti-inflammatory drug use, race, family history of GERD, education level, employment status, tobacco smoking, alcohol, or coffee drinking were not associated significantly with adulthood GERD. Frequent GERD symptoms requiring antisecretory therapy are present in approximately half of young adults with a history of childhood GERD. The use of oral contraceptives is a risk factor for GERD symptoms in these individuals.