Dietary guideline adherence for gastroesophageal reflux disease.

Ai Kubo,Gladys Block,Patricia Buffler,Charles P Quesenberry,Douglas A Corley

doi:10.1186/1471-230x-14-144

Abstract

BackgroundGastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Recently described side effects of long-term acid suppression have increased the interest in nonpharmacologic methods for alleviating GERD symptoms. We aimed to examine whether GERD patients follow recommended dietary guidelines, and if adherence is associated with the severity and frequency of reflux symptoms.MethodsWe conducted a population-based cross-sectional study within the Kaiser Permanente Northern California population, comparing 317 GERD patients to 182 asymptomatic population controls. All analyses adjusted for smoking and education.ResultsGERD patients, even those with moderate to severe symptoms or frequent symptoms, were as likely to consume tomato products and large portion meals as GERD-free controls and were even more likely to consume soft drinks and tea [odds ratio (OR) = 2.01 95% confidence interval (CI) 1.12-3.61; OR = 2.63 95% CI 1.24-5.59, respectively] and eat fried foods and high fat diet. The only reflux-triggering foods GERD patients were less likely to consume were citrus and alcohol [OR = 0.59; 95% CI: 0.35-0.97 for citrus; OR = 0.41 95% CI 0.19-0.87 for 1 + drink/day of alcohol]. The associations were similar when we excluded users of proton pump inhibitors.ConclusionsGERD patients consume many putative GERD causing foods as frequently or even more frequently than asymptomatic patients despite reporting symptoms. These findings suggest that, if dietary modification is effective in reducing GERD, substantial opportunities for nonpharmacologic interventions exist for many GERD patients.

Highlights

Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high
Study population Of the GERD patients and population controls from the original study, dietary data were available for 622 subjects (98% of interviewed subjects)
Beverage choice and gastroesophageal reflux symptoms Patients with moderate to severe GERD symptoms were over twice as likely as GERD-free controls to consume soft drinks, adjusting for smoking and education [odds ratio (OR) = 2.11, 95% confidence interval (CI):1.16-3.84] (Table 3); there was no association with GERD frequency (Table 4)

Summary

Introduction

Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disease, and the cost of health care and lost productivity due to GERD is extremely high. Gastroesophageal reflux disease (GERD) is one of the most common illnesses in the United States. The cost of health care and lost productivity due to GERD is estimated at over $24 billion annually in the US alone [5,6,7], 60% of which is used for medication [8]. The annual average medical costs and services for patients with GERD may be twice that of the non-GERD population due to additional outpatient visits, hospitalizations, emergency department utilization, and pharmacy costs [5]. The quality of life in GERD patients is compromised: the impact of GERD on quality of life measures is similar to that of other chronic diseases such as diabetes, heart failure, or ischemic heart disease [9]

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