Gastroesophageal Reflux Disease Questionnaire Research Articles

The traditional medicine patterns in GERD patients at University Medical Center HCMC: a cross-sectional survey

Gastroesophageal reflux disease (GERD) is a prevalent condition with growing interest in traditional medicine (TM) treatment. However, there is a dearth of TM epidemiological data on GERD in Vietnam. This study aimed to examine the prevalence of TM patterns and evaluate their association with the severity of GERD to lay the groundwork for clinical practice. This cross-sectional study was conducted at the University Medical Center Ho Chi Minh City, from December 2021 to May 2022. GERD patients diagnosed by gastroenterologists were enrolled in the survey. The PIGERD tool was used to classify patients into TM patterns. Demographic characteristics and GERD questionnaire (GERDQ) scores were also collected. Statistical analyses were performed to determine the proportion of each TM pattern and the distribution of GERDQ scores within each pattern. Among the 384 surveyed GERD patients, the Liver qi invading Stomach (LQIS) pattern had the highest proportion (49.2%), followed by Spleen-Stomach weakness (24.7%), Spleen-Stomach dampness-heat (13.3%), and Stomach yin deficiency (12.8%). The LQIS pattern also exhibited the highest GERDQ score (median [interquartile range] of 9 [7, 10]), which significantly differed from the other patterns (p=0.0001). The remaining three patterns had lower GERDQ scores, and the differences were not statistically significant (p>0.05). LQIS pattern was the most prevalent among GERD patients and had the highest severity. Further multicenter studies are recommended to confirm these findings.

Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease.

The efficacy and safety of anti-reflux mucosectomy (ARMS) or radiofrequency energy delivery in the treatment of gastroesophageal reflux disease (GERD) have been reported, but the difference between the 2 remains unclear. This was a single center, randomized, comparative clinical study. Patients with symptoms of heartburn and/or regurgitation despite proton pump inhibitor treatment were randomly assigned to either ARMS group (n = 20) or radiofrequency group (n = 20). Primary outcome was the standardized GERD questionnaire (GERDQ) at 2 years after the procedures. Secondary outcomes were the proportions of patients with complete proton pump inhibitor (PPI) cessation and patients satisfied with the treatment. A total of 18 patients randomized to ARMS and 16 to radiofrequency were analyzed in this study. The operation success rate of the 2 groups was 100%. In both ARMS and radiofrequency groups, GERDQ scores at 2 years after the procedures were significantly lower than that before operation (P = 0.044 and P = 0.046). At 2 years postoperatively, the scores of GERDQ did not differ between the 2 groups (P = 0.755). There was no significant difference in the rate of discontinuation of PPIs and patient satisfaction in the ARMS and radiofrequency groups (P = 0.642 and P = 0.934). The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD.

Diagnostic accuracy of gastroesophageal reflux disease questionnaire for gastroesophageal reflux disease: A systematic review and meta-analysis.

The use of a symptom-based gastroesophageal reflux disease (GERD) questionnaire (GerdQ) for GERD diagnosis has gained interest due to its greater efficacy and ease of use than other available questionnaires. However, different guidelines have given inconsistent recommendations regarding using GerdQ as a diagnostic test. This meta-analysis summarized the diagnostic accuracy of GerdQ for diagnosing GERD. Studies published up to April 12, 2023, and indexed in MEDLINE, EMBASE, SCOPUS, Web of Science, and the Cochrane Library were searched. Diagnostic test accuracy studies comparing GerdQ with upper endoscopy and/or pH-metry for GERD diagnosis in adult patients with symptoms suggestive of GERD were included. The study quality was assessed using the QUADAS-2 tool. Meta-analysis using bivariate (Reitsma) analysis was done to summarize the overall sensitivity, specificity, likelihood ratios (LRs), and diagnostic odds ratio (DOR). The summary receiver operating characteristics (SROC) curve was visualized, and the area under the ROC (AUC) was calculated. A total of 13 studies with 11,166 participants were included in the meta-analysis. The pooled sensitivity, specificity, positive LR, negative LR, and DOR for GerdQ (cut-off value of ≥8) were 66.9% (95% CI 56.4%-73.1%), 65.2% (95% CI 56.4%-73.1%), 1.93 (95% CI 1.55-2.42), 0.51 (95% CI 0.38-0.66), and 3.89 (95% CI 2.44-5.89), respectively. The overall AUC from the SROC was 0.705. The subgroup analysis showed similar pooled sensitivity, specificity, and DOR between Asian and non-Asian studies. GerdQ had moderate sensitivity and specificity for GERD diagnosis. GerdQ can still be recommended as a diagnostic tool for GERD, especially when the PPI test is unavailable or contraindicated.

Clinical effects of robot-assisted esophageal hiatal hernia repair and laparoscopic esophageal hiatal hernia repair: a retrospective comparative study

Objective: To analyze the short-term clinical effects of robot-assisted and laparoscopic repair of the hiatal hernia. Methods: The clinical data of 56 patients underwent minimally invasive hiatal hernia repair from January 2021 to January 2022 in the Department of Minimally Invasive Surgery, Hernias and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. There were 32 males and 24 females, aging (59.7±10.7) years (range: 28 to 75 years). All patients were divided into laparoscopy group (n=27) and robot group (n=29) according to surgical procedures. Perioperative conditions, hospital stay, and improvement in symptoms before and after surgery were compared between the two groups by the t test, Wilcoxon rank-sum test and χ2 test. Results: All surgical procedures were successfully completed, without conversion to laparotomy or change in operation mode. There were no serious complications related to the operation. The intraoperative blood loss of the robot group was less than that of the laparoscopic group (M (IQR)): (20 (110) ml vs. 40 (80) ml, Z=-4.098, P<0.01). The operation time ((111.7±33.6) minutes vs. (120.4±35.0) minutes, t=-0.943, P=0.350) and hospitalization time ((3.9±1.4) days vs. (4.7±1.9) days, t=-1.980, P=0.053) of the robot group and the laparoscopic group were similar. Follow-up for 12 months after the operation showed no postoperative complications and recurrence. The score of the health-related quality of life questionnaire for gastroesophageal reflux disease in the robot group decreased from 10.8±2.8 before the operation to 6.5±0.6 after the operation, and that in the laparoscopic group decreased from 10.6±2.1 before the operation to 6.3±0.6 after the operation. There was no difference in the influence of different surgical methods on the change in score (t=0.030,P=0.976). Conclusion: Compared with laparoscopic repair of the hiatal hernia, robot-assisted hiatal hernia repair has the advantages of less bleeding, rapid postoperative recovery and good short-term effect.

Clinical influence of conversion of laparoscopic sleeve gastrectomy to one anastomosis gastric bypass on gastroesophageal reflux disease

Assess the subjective impact of gastro-esophageal reflux disease (GERD) symptoms on patients undergoing revision from laparoscopic sleeve gastrectomy (LSG) to one-anastomosis gastric bypass (OAGB) using the Reflux Disease Questionnaire for GERD (RDQ) and the GERD-health related quality of life score (GERD-HRQL), prior to- and following conversion. Patients undergoing revision from LSG to OAGB were prospectively followed between May 2015 and December 2020. Data retrieved included demographics, anthropometrics, previous bariatric history, time interval between LSG and OAGB, weight loss, and co-morbidities. Pre- and post-OAGB RDQ and GERD-HRQL questionnaires were obtained. In the case of sleeve dilatation, sleeve resizing was performed. During the study period, 37 patients underwent revision from LSG to OAGB. Mean ages at LSG and pre-OAGB were 38 ± 11.74 and 46 ± 12.75, respectively. Median follow-up time was 21.5months (range 3-65). All patients underwent sleeve resizing. RDQ and GERD-HRQL scores were obtained at a median of 14months (range 3-51) between pre- and post-OAGB. Median RDQ score pre-OAGB vs post-OAGB was significantly reduced (30 (range 12-72) vs 14 (range 12-60), p = 0.007). All 3 parts of the GERD- HRQL questionnaires were significantly reduced between pre-OAGB and post-OAGB: Symptoms (20; 62.5% vs 10; 31.3%, p = 0.012), overall score (15 (0-39) vs 7 (0-28), p = 0.04) and subjective improvement (10; 31% vs 20; 62.5%, p = 0.025). Conversion of LSG to OAGB showed subjective improvement of GERD symptoms both in RDQ and in GERD-HRQL.

Biochemical and Physiological Effects of Food-Induced Gastro-Esophageal Reflux Disease (GERD) in our Population. A Comparative Clinical Study

Background: Gastroesophageal reflux disease (GERD) can lead to significant medical complications such as esophageal ulcerations, peptic stenosis and esophageal adenocarcinoma. Aims and Objectives: The aims and objectives of current study was to evaluate the biochemical and physiological parameters associated with daily food which caused gastroesophageal reflux disease in population of Pakistan. Study Design: This was a comparative clinical study designed to investigate the effect of different dietary interventions on the symptoms of gastroesophageal reflux disease (GERD). Place and Duration: Current study was conducted medical units of Jinnah Hospital Lahore and Jinnah Hospital Karachi from June 2022 to February 2023 comparatively. Statistical analysis: Raw data was analyzed by using SPSS software (version 26.0). Descriptive statistics were used to summarize demographic and clinical characteristics of the study population. Methodology: A total of 100 adult patients with confirmed GERD diagnosis were randomized to either a standard GERD diet. The primary outcome measure was the change in GERD symptom severity, as assessed by the Gastroesophageal Reflux Disease Questionnaire (GERDQ) score after 12 weeks of dietary intervention. Secondary outcome measures included changes in esophageal inflammation, measured by endoscopy, and patient-reported improvement in quality of life. Practical Implications: Current study focuses on evaluation of the biochemical and physiological parameters associated with daily food which caused gastroesophageal reflux disease in population of Pakistan which will spread awareness among community for the prevention of GERD. Results: Demographic characteristics of the study population are presented in Table 1. The mean age of the patients was 48.7 years, and there were slightly more females (60%) than males (40%). The majority of patients (60%) reported a history of smoking, and 10% reported regular alcohol consumption. There was a significant (P≤0.05) difference between the two groups with respect to age, sex, smoking history and alcohol consumption. The findings of this study suggest that dietary interventions, particularly a modified Mediterranean diet, can significantly improve the symptoms and quality of life of patients with GERD. Conclusion: In conclusion, our study found that a modified Mediterranean diet may be more effective than a standard GERD diet in reducing the severity of GERD symptoms and improving quality of life in patients with GERD. This was evidenced by a significantly greater reduction in GERD score in Group B compared to Group A, as well as a higher proportion of patients reporting improved quality of life in Group B. In addition, the incidence of esophageal inflammation was lower in Group B, although this difference was not statistically significant. Keywords: dietary intervention, Mediterranean diet, symptom severity, quality of life, esophageal inflammation,

Effects of Helicobacter pylori eradication on esophageal motility, esophageal acid exposure, and gastroesophageal reflux disease symptoms.

The effects of Helicobacter pylori (HP) eradication on gastroesophageal reflux disease (GERD) are yet to be fully elucidated. Few studies have investigated the mechanisms underlying the correlations between HP and GERD with prospective methods. The objective of this prospective clinical study was to explore the effects of HP eradication on GERD. Patients diagnosed with both GERD and HP were included. High-resolution esophageal manometry (HRM), 24-h esophageal pH monitoring, and the Gastroesophageal Reflux Disease Questionnaire (GerdQ) were performed before and after the successful eradication of HP, and the data were compared using statistical analysis. Sixty-eight patients diagnosed with both GERD and HP were included. The After HP eradication group showed significantly decreased median distal contractile integral (DCI) [610.40 (847.45) vs. 444.90 (559.60)] and significantly increased median inefficient esophageal motility (IEM) [36.00 (50.00) vs. 60.00 (57.00)] in the HRM compared with those of the Before HP eradication group, indicating that HP eradication reduced esophageal peristalsis. The 24-h esophageal pH monitoring showed that the longest reflux event, the percentage of time that the pH was <4, the number of reflux episodes, and the DeMeester score were all significantly different between the Before and After HP eradication groups (P < 0.05), suggesting that HP eradication increased esophageal acid exposure. The After HP eradication group also had a significantly higher GerdQ score than that of the Before HP eradication group (P < 0.05). HP eradication reduced esophageal peristalsis, enhanced esophageal acid exposure, and aggravated GERD symptoms, suggesting that HP infection may be a protective factor for GERD.

The long-term efficacy of transoral incisionless fundoplication with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease

BackgroundTo evaluate the long-term efficacy of transoral incisionless fundoplication (TIF) with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease (GERD).MethodsA total of 16 patients with proton pump inhibitor-dependent gastroesophageal reflux disease had undergone TIF by MUSE in Shanghai General Hospital （Shanghai, China）from March 2017 to December 2018. Patients were followed up at 6 months, and the GERD-health-related quality of life (GERD-HRQL) questionnaire score, the GERD questionnaire (GERD-Q) score, high-resolution esophageal manometry (HREM) and 24 h esophageal pH parameters, the Hill grade of the gastroesophageal flap valve (GEFV) and daily Proton pump inhibitor (PPI) consumption before and after procedure were compared. Patients also were followed up at 3 years and 5 years using a structured questionnaire via phone which evaluated symptoms of reflux, dose of PPI medication and side effects.ResultsFollow-up data were collected from 13 patients, ranging from 38 to 63 months, 53 months on average. 10/13 patients reported symptomatic improvement and daily PPI consumption was stopped or halved in 11/13. After procedure, the mean scores of GERD-HRQL and GERD-Q were significantly increased. The mean DeMeester score, the mean acid exposure time percentage and the mean number of acid reflux episodes were significantly lower. The mean rest pressure at lower esophageal sphincter (LES) had no significant difference.ConclusionTIF by MUSE has significant efficacy in the treatment of PPI-dependent GERD, which can improve symptoms and life quality of patients, and reduce the acid exposure time for long-term. Chictr.org.cn.Trial RegistrationChiCTR2000034350.

A comprehensive analysis of partial peristalsis recovery after peroral endoscopic myotomy in patients with achalasia.

To determine whether peroral endoscopic myotomy (POEM) improves esophageal peristalsis and to investigate the association between recovery of esophageal peristalsis after POEM and clinical features of the patients. In this single-center retrospective study, data were collected from medical records of the patients with achalasia who underwent POEM between January 2014 and May 2016. Demographics data, high-resolution esophageal manometry parameters, Eckardt score, and gastroesophageal reflux disease questionnaire (GERD-Q) score were collected. Weak and fragmented contraction was defined as partial recovery of esophageal peristalsis based on the Chicago classification version 3.0. Logistic regression analysis was used to identify variables associated with the partial recovery of peristalsis after POEM. A total of 103 patients were enrolled. Esophageal contractile activity was observed in the distal two-thirds of the esophagus in 24 patients. The Eckardt score, integrated relaxation pressure, and lower esophageal sphincter (LES) resting pressure were significantly decreased after POEM. Multivariate analysis revealed that preprocedural LES resting pressure (P = 0.013) and preprocedural Eckardt score (P = 0.002) were related to the partial recovery of peristalsis after POEM. Symptoms of gastroesophageal reflux and reflux esophagitis after POEM were less frequent in those with partial recovery of peristalsis (both P < 0.05). Normalization of esophagogastric junction relaxation pressure achieved by POEM is associated with the partial recovery of esophageal peristalsis in patients with achalasia. Preprocedural LES resting pressure and the Eckardt score are predictive of the recovery of esophageal peristalsis.

Dietary approaches to stop hypertension (DASH)-style diet in association with gastroesophageal reflux disease in adolescents

BackgroundDietary patterns and food items have been associated with gastroesophageal reflux disease (GERD) risk and they have led to conflicting findings. The aim of this study was to determine the association between a dietary approach to stop hypertension (DASH)-style diet with the risk of GERD and its symptoms in adolescents.Study designCross-sectional.MethodsThis study was performed on 5,141 adolescents aged between 13 and 14 years. Dietary intake was evaluated using a food frequency method. The diagnosis of GERD was done by using a six-item GERD questionnaire that asked about GERD symptoms. A binary logistic regression was used to assess the association between the DASH-style diet score and GERD and its symptoms in crude and multivariable-adjusted models.ResultsOur findings revealed that after adjustment for all confounding variables, the adolescents with the highest adherence to the DASH-style diet had a lower chance of developing GERD [odds ratio (OR) = 0.50; 95%CI 0.33–0.75, Ptrend< 0.001)], reflux (OR = 0.42; 95%CI 0.25–0.71, Ptrend=0.001), nausea (OR = 0.59; 95% CI:0.32–1.08, Ptrend=0.05) and stomach pain (OR = 0.69; 95%CI 0.49–0.98, P trend=0.03) compared to those with the lowest adherence. Similar results were found for odds of GERD among boys, and the total population (OR = 0.37; 95%CI: 0.18–0.73, Ptrend=0.002, OR = 0.51; 95%CI: 0.34–0.77, P trend<0.0, respectively).ConclusionThe current study revealed that adherence to a DASH-style diet might protect against GERD and its symptoms including, reflux, nausea, and stomach pain in adolescents. Further prospective research is needed to confirm these findings.

Evaluation of Salivary Pepsin Levels and Dental Erosion in Patients With Gastroesophageal Reflux Disease.

Background Gastroesophageal reflux disease (GERD) is a common gastrointestinal condition affecting many individuals worldwide. GERD is characterized by esophageal symptoms and may contribute to various extraesophageal symptoms, including dental erosion (DE). This study aimed to estimate the levels of pepsin in the saliva of GERD patients to evaluate and compare the activity of pepsin between the GERD and healthy groups and investigate the prevalence of DE in the GERD group. Methodology In this case-control study, 40 patients with GERD, diagnosed with an endoscope, and 35 healthy subjects were included.Patients and healthy individuals were subjected to the GERD questionnaire (GerdQ). A dental assessment was performed using the Basic Erosive Wear Examination (BEWE).A total score of the BEWE risk level was obtained by summing the scores obtained in each sextant (no risk = ≤2, low risk = 3-8, medium risk = 9-13, and high risk = >13). Five milliliters of unstimulated saliva were collected in a sterile tube. The salivary pepsin levels examined using the enzyme-linked immunosorbent assay were recorded for both groups. Results DE was significantly more frequent in GERD patients compared to healthy subjects. Overall, 32 (80%) GERD patients and 11(31.4%) healthy individuals had DE risk. The mean salivary pepsin was 43.60 ± 10.61 ng/mL in the GERD group and 20.60 ± 9.27 ng/mL in the healthy group. A statistically significant difference was found in pepsin levels between the two groups (p < 0.001). Conclusions The study concluded that GERD patients had a higher prevalence of DE than healthy individuals. Our findings suggest that elevated salivary pepsin levels and their role as a factor responsible for DE need further evaluationto understand the mechanisms of pepsin-mediated damage leading to DE.

Exploration of esophageal hypervigilance and anxiety status in patients with symptomatic gastroesophageal reflux disease: A single‐center study in Taiwan

AbstractThe esophageal hypervigilance and anxiety scale (EHAS) is a valuable cognitive‐affective evaluation of visceral sensitivity, which has been demonstrated to associate with gastroesophageal reflux disease (GERD) symptom severity and psychological stress. We aimed to obtain the values for EHAS in the setting of patients who underwent esophagogastroduodenoscopy (EGD) without GERD symptoms and investigate potential clinical factors contributing level of EHAS in symptomatic patients. Patients scheduled EGD with or without GERD symptoms were prospectively enrolled for assessing patient‐reported outcomes, including EHAS and GERD questionnaire (GERDQ). Patients without GERD symptoms had GERDQ ≤8 were classified as controls. Potential factors influencing the level of EHAS were identified via generalized linear model. We enrolled 534 patients, aged 20 to 84 years (mean, 52.78), of whom 54.2% were female; 110 had GERD symptoms, and 418 were controls. Patients with GERD symptoms had higher EHAS levels than controls (28.7 vs 10.2, P &lt; .001). On generalized linear model GERDQ scores and female gender positively correlated with EHAS (GERDQ, β = 2.254, P &lt; .001; female, β = 3.828, P = .001). In summary, our study suggests that greater esophageal hypervigilance and anxiety are associated with reflux symptoms burden across the spectrum of GERD, and correlate with female gender too.

A novel modified method for treating patients with refractory gastro-esophageal disease and moderate hiatus hernia.

Endoscopic anti-reflux mucosectomy (ARMS) is effective for patients with refractory gastroesophageal reflux disease (rGERD) with small hiatus hernia. However, evidence of its applicability on larger lesions is lacking. This study aimed to evaluate the efficiency and safety of ARMS for patients with rGERD with moderate hiatus hernia (3-5 cm) and determine the appropriate resection range (either 2/3 or 3/4 circumference). Thirty-six patients with rGERD with moderate hiatus hernia were enrolled. They were divided into the 2/3 and 3/4 circumferential mucosal resection groups. The patients received modified ARMS. The gastroesophageal reflux disease questionnaire (GERD-Q) and DeMeeter scores, endoscopy, 24-h pH monitoring results, and lower esophageal sphincter (LES) resting pressure were compared pre and post procedure. The therapeutic effects and complications of the two mucosal resection ranges were analyzed. Thirty-six patients were enrolled in this study, all of whom had undergone ARMS operation with at least 6 months of follow-up. In the 2/3 circumferential mucosal resection group, the GERD-Q score, acid exposure time (AET), and DeMeester score improved significantly compared with those before operation (P<0.001). In the 3/4 circumferential mucosal resection group, the GERD-Q score, AET, and DeMeeter score worsened after six months (P<0.001), but there was no difference between the two groups (P>0.05). In both groups, there was no significant improvement in the ratio of esophagitis grade C/D and LES resting pressure after treatment compared with the baseline values (P>0.05) and no postoperative bleeding or perforation. The incidence of postoperative esophageal stenosis in the 2/3 circumferential mucosal resection group was lower than those in the 3/4 circumferential mucosal resection group (P=0.041). Modified ARMS is effective for patients with rGERD with moderate hiatus hernia, but it cannot significantly increase the postoperative resting pressure of LES. The 2/3 circumferential mucosal resection can reduce the incidence of postoperative esophageal stenosis.

Impaired cough-related quality of life in patients with nontuberculous mycobacteriosis.

Cough and sputum are the significant symptoms of nontuberculous mycobacteriosis (NTM) and impair quality of life (QOL). However, the relationship between these symptoms and clinical features is not fully understood. This study aimed to investigate cough-related QOL in NTM patients. The study subjects included 78 patients with NTM at our hospital from October to December 2015. They completed the Leicester Cough Questionnaire (LCQ) and the Cough and Sputum Assessment Questionnaire (CASA-Q) (both questionnaires: the higher, the better); the Frequency Scale for the Symptoms of gastroesophageal reflux disease (GERD) (FSSG), a validated Japanese questionnaire for GERD (the higher, the worse), was also assessed. The FSSG consists of 12 items, including the reflux-related symptoms and dysmotility symptoms domains, each of which is quantified on a scale of 0-4 points, and the cut-off score for GERD is set at 8 points. Associations between these scores and clinical parameters were assessed. The total LCQ score was reduced-the physical domain was dominant. The total LCQ and CASA-Q scores were reduced, with dominance in the physical and symptoms domains, respectively. The reflux-related symptoms score was higher than the dysmotility symptoms score. A multivariate linear regression analysis revealed that the mean total LCQ score was independently associated with current smoking, fibrocavitary type, bilateral cavitary lesion, and FSSG total score. Cough-related QOL was impaired in NTM patients who currently smoked, had radiological characteristics, and had GERD.

Prevalence, General and Periodontal Risk Factors of Gastroesophageal Reflux Disease in China.

There is insufficient information about the prevalence and risk factors of gastroesophageal reflux disease (GERD) in the Chinese adult population. We aimed to assess the prevalence and identify the risk factors of GERD in China. We collected data from a nationally representative sample (50,991 subjects) of Chinese adults from a large nation-wide cross-sectional survey. GERD was diagnosed by a standardized Chinese-language GERD questionnaire with a score of ≥ 8. The demographic characteristics, comorbidities and periodontal factors of all participants were collected. Fifty-thousands-one-hundred-eighty-three participants were finally included in this study. The overall prevalence of GERD was 5.6% (95% CI, 5.4-5.8%) among the general Chinese population aged 20 years or older. Women, smokers, and people with older age, BMI ≥ 25.0 kg/m2, urban residence, lower education level or comorbidities were more prevalent with GERD (p < 0.001). Symptoms of severe periodontitis (OR = 1.40, 95% CI 1.28-1.52, p < 0.001) and lower frequency of tooth brushing (OR = 2.01, 95% CI 1.76-2.29, p < 0.001) were significantly associated with risk of GERD. Symptom-based GERD is highly prevalent in the Chinese population. Overweight and smoking are major preventable risk factors for GERD. Periodontal factors are novel potential risk factors for GERD and should be given more attention in GERD prevention.

Investigation of the potential relationship between gastroesophageal reflux disease and laryngopharyngeal reflux disease in symptomatology – a prospective study based on a multidisciplinary outpatient

Objective To investigate the relationship between laryngopharyngeal reflux disease (LPRD) and gastroesophageal reflux disease (GERD). Methods Gastroesophageal Reflux Disease Questionnaire (GERD-Q) and Reflux Symptom Index (RSI) scale were administered to patients attending the gastroenterology outpatient clinic at the Sixth Medical Center of the PLA General Hospital from 7 April 2021 to 10 June 2021. Patients with GERD-Q score >7 were indicated GERD, and patients with RSI >13 were indicated LPRD. The analysis of patients with pure GERD (independent GERD, iG), patients with LPRD and GERD (LPRD & GERD, L&G), patients with simple LPRD (independent LPRD, iL) and the percentage of normal group (GERDQ-negative and RSI-negative, N). Results 3060 GERD-Q and RSI questionnaires were distributed, and 2974 complete questionnaires were returned. Among them, 274 (9.20%) iL, 334 (11.23%) iG and 151 (5.10%) L&G patients and 2215 (74.48%) N patients. The positive rate of GERD in this sample was 16.31%, of which 31.13% had coexisting LPRD, and the positive rate of LPRD was 14.29%, of which 35.53% had coexisting GERD. Among patients with LPRD, the positive rate of concomitant GERD (χ 2 = 4.157, p = 0.041) and RSI score (Z = −6.823, p = 0.000) was significantly higher in patients with the presence of respiratory symptoms than in those without respiratory symptoms. Conclusion LPRD can exist alone or in conjunction with GERD. Patients with both LPRD and GERD had the most severe reflux symptoms. The need to focus on the risk of those initially screened only with GERD developing LPRD. Respiratory symptoms play an important role in reflux disease.

Esophageal Hypervigilance and Visceral Anxiety Contribute to Symptom Severity of Laryngopharyngeal Reflux.

Laryngopharyngeal reflux (LPR) is a clinical conundrum without a diagnostic gold standard. The Esophageal Hypervigilance and Anxiety Scale (EHAS) is a questionnaire designed for cognitive-affective evaluation of visceral sensitivity. We hypothesized that esophageal hypervigilance and symptom-specific anxiety have an etiopathological role in generation of LPR symptoms, especially when gastroesophageal reflux disease (GERD) cannot explain these symptoms. Consecutive patients with LPR and/or GERD symptoms lasting >3 months were prospectively enrolled and characterized using the Reflux Symptom Index, GERD questionnaire, and EHAS. Eligible patients with negative endoscopy underwent 24-hour impedance-pH monitoring off acid suppression for phenotyping GERD and assessment of reflux burden, using conventional metrics (acid exposure time and number of reflux episodes) and novel metrics (mean nocturnal baseline impedance and postreflux swallow-induced peristaltic wave index). Of 269 enrolled patients (mean age 47.1 years, 21-65 years, 60.6% female), 90 patients were with concomitant GERD and LPR symptoms, 32 patients were with dominant LPR symptoms, 102 patients were with dominant GERD symptoms, and 45 were controls. Patients with concomitant GERD and LPR symptoms had higher EHAS than those with dominant GERD symptoms and controls ( P ≤ 0.001); patients with dominant LPR symptoms had higher EHAS than controls ( P = 0.007). On Pearson correlation, EHAS positively correlated with the Reflux Symptom Index. Esophageal hypervigilance and symptom-specific anxiety may be more important than reflux burden in LPR symptom perception.

From Chicago classification v3.0 to v4.0: Diagnostic changes and clinical implications.

The Chicago Classification (CC) used to define esophageal motility disorders in high-resolution manometry (HRM) has evolved over time. Our aim was to compare the frequency of motility disorders diagnosed with the last two versions (CCv3.0 and CCv4.0) and to evaluate symptoms severity according to the diagnoses. From June to December 2020, patients who underwent esophageal HRM with swallows in supine and sitting positions were included. HRM studies were retrospectively analyzed using CCv3.0 and CCv4.0. Symptoms severity and quality of life were assessed with validated standardized questionnaires. Among the 130 patients included (73 women, mean age 52 years), motility disorder diagnoses remained unchanged in 102 patients (78%) with both CC. The 3 patients with esophago-gastric junction outflow obstruction (EGJOO) with CCv3.0 were EGJOO, ineffective esophageal motility (IEM) and normal with CCv4.0. Twenty-four out of 63 IEM diagnosed with the CCv3.0 (38%) turned into normal motility with the CCv4.0. Whatever the CC used, brief esophageal dysphagia questionnaire score was significantly higher in patients with EGJ relaxation disorders compared to those with IEM (25 (0-34) vs 0 (0-19), p= 0.01). Gastro-Esophageal Reflux disease questionnaire (GERD-Q) score was higher in patients with IEM with both CC compared to those who turned to normal with CCv4.0. While motility disorders diagnoses remained mainly unchanged with both CC, IEM was less frequent with CCv4.0 compared to CCv3.0. The higher GERD-Q score in IEM patients with CCv4.0 suggests that CCv4.0 might identify IEM more likely associated with GERD.

Clinical Implications of the Gastroesophageal Reflux Disease Questionnaire and Reflux Symptom Index in Patients With Suspected Laryngopharyngeal Reflux Symptoms.

Background/AimsTo evaluate the usefulness of gastroesophageal reflux disease questionnaire (GerdQ) and reflux symptom index (RSI) for diagnosis of gastroesophageal reflux disease (GERD) in patients with suspected laryngopharyngeal reflux (LPR) symptoms (cough, hoarseness, globus, and throat pain).MethodsA total of 98 patients with LPR symptoms were incorporated from either gastroenterology or otorhinolaryngology clinic. Patient’s laryngoscopic findings were graded by reflux finding score (RFS), and RFS ≥ 7 was considered as positive LPR. Erosive esophagitis on endoscopy or abnormal results on ambulatory impedance-pH monitoring were used as diagnostic criteria for GERD. Esophageal motor function was evaluated using high-resolution esophageal manometry.ResultsNinety-three (94.9%) of the 98 subjects were diagnosed as LPR by RFS, but only 15 (15.3%) had GERD. For GerdQ, the cutoff value of 9 showed the highest area under curve (AUC) to diagnose GERD by receiver operating curve analysis (AUC = 0.565); the sensitivity, specificity, positive predictive value, and negative predictive value were unsatisfactory (50.0%, 70.7%, 22.6%, and 89.2%, respectively.) RSI also showed poor performance in diagnosing GERD; the cutoff value of 25 showed the highest yield (AUC = 0.581); the sensitivity, specificity, positive predictive value, and negative predictive value were 42.9%, 79.3%, 26.1%, and 89.0%, respectively. Ineffective esophageal motility was frequently observed (69 of 98, 70.4%), but there was no difference in esophageal motility parameters between GERD and non-GERD patients.ConclusionsIn patients with LPR symptoms, significant discrepancies are observed between laryngoscopic diagnosis and GERD. In this population, neither GerdQ nor RSI is useful in diagnosing GERD.

ROLE OF PSYCHOEMOTIONAL FACTORS IN THE DEVELOPMENT OF GASTROESOPHAGEAL REFLUX DISEASE IN CHILDREN: CHARACTER FEATURES

At the moment, a huge amount of indisputable evidence has been accumulated of the connection of a person’s psycho-emotional state with the development of gastroesophageal reflux disease (GERD). Despite this, there is no single idea of the exact cause-and-effect relationships that occur when this pathology occurs. In addition, studies of this problem in children are very few.&#x0D; Purpose: to establish the features of the psycho-emotional sphere in children with GERD and analyze their role in the development of GERD using the system-vector psychology of Yuri Burlan (SVP).&#x0D; Materials and methods of research. 677 children aged 11 to 17 years were examined in the pediatric department of the Clinic of the Research Institute of Medical Problems of the North (Krasnoyarsk). GERD was diagnosed based on the results of testing according to the Russian version of the Gastroesophageal Reflux Disease Questionnaire (GerdQ). R. Goodman’s questionnaire “Strengths and Difficulties” (SDQ) was used to characterize the psycho-emotional state of children. Panic attacks and asthenic syndrome were determined by specially developed and previously tested questionnaires (author D.M.N., Prof. Tereshchenko S.Yu.). To determine the strengths of the character, testing was used in the computer program “The Development and Well-Being Assessment” (DAWBA, R. Goodman et al.).&#x0D; The results of the study prove the existence of causal relationships presented in the SVP between the established character traits (emotional lability, propensity for art, charity, attachment to loved ones, the desire to establish emotional connections, as well as the ability to study well at school) and the development of GERD.