Gastroesophageal Reflux Disease Questionnaire Score Research Articles

Association Between Esophagitis Severity and GERDQ Score, Sleep, Life Quality among GERD Patients

Background: Gastroesophageal reflux disease (GERD) is characterized with acid reflux, therefore may lead to esophagitis. Acid reflux may cause night symptom of GERD, therefore resulting in decreased sleep and life quality. Gastroesophageal reflux disease questionnaire (GERDQ) is a simple and validated questionnaire for diagnosing GERD. This article aims to investigate association between esophagitis severity and GERDQ score, sleep, life quality among GERD patients at Prof. Dr. R.D. Kandou Hospital.Method: An analytic-cross-sectional study was conducted in gastroenterology clinic of Prof. Dr. R.D. Kandou Hospital between May–June 2021. We included all patients with reflux esophagitis that proven by esophagoduodenoscopy and the severity was graded using Los-Angeles criteria. The GERDQ score was calculated in all patients. The analysis of sleep and life quality was assessed using validated Indonesian version of Pittsburgh-Sleep-Quality-Index (PSQI) and WHO-quality-of-life-BREF (WHOQOLBREF) questionnaire. Independent T-test was used to compare GERDQ, PSQI, WHOQOLBREF score with esophagitis severity degree.Results: Among 30 patients with esophagitis, 70% was male. We found 22 patients with Los-Angeles-grade-A and 8 patients with Los-Angeles-grade-B. The analysis showed no significant different between GERDQ score with esophagitis grade (p = 0.753). There was no association between esophagitis grade with sleep quality (p = 0.125), physical health (p = 0.161), psychological health (p = 0.728), and environmental health (p = 0.133). But we found significant association between esophagitis grade with social relationship life quality (p = 0.028).Conclusion: Patients with higher esophagitis degree had lower social relationship, but not associated with another domain of WHOQOLBREF, sleep quality, and GERDQ score.

The Relationship of Body Mass Index with Gastroesophageal Reflux Disease based on Gastroesophageal Reflux Disease Questionnaire Score in Dinas Bina Marga and Bina Konstruksi of North Sumatera

Abstract. Introduction: Gastroesophageal Reflux Disease (GERD) is a pathological condition due to the reflux of stomach contents back into the esophagus that causing symptoms. In Indonesia, there is no clear prevalence of the incidence of GERD. Some risk factors that can cause GERD are age, sex, race, family history, economic status, increased body mass index (BMI) to obesity and smoking. BMI is the most useful and practical indicator for measuring body fat. It is known that an increased BMI can increase the risk for the occurrence of GERD. Objective: Knowing the relationship between BMI and GERD based on the GERD-Q score at the Dinas Bina Marga dan Bina Konstruksi of North Sumatra province. Methods: This research is an analatic study using cross-sectional method. Sampling using simple random sampling. The sample of this study using Gastroesophageal Reflux Disease Questionnaire (GERD-Q) for GERD diagnosis tool and measurement of weight and height to get BMI. Results: The analysis results obtained by Kendalls Tau-b correlation test and found p = 0.773 (p < 0.005). Conclusion: There was no significant relationship between BMI and GERD based on GERD-Q scores on employees of the Dinas Bina Marga dan Bina Konstruksi of North Sumatera. Keywords: Body Mass Index, GERD, GERD-Q

Prevalence and Risk Factors for Gastroesophageal Reflux Disease (GERD) Among Visitors to the Health Center of Imam Mohammad Ibn Saud Islamic University.

A considerable majority of people have gastroesophageal reflux disease (GERD), a common gastrointestinal ailment. Globally, the prevalence of GERD has been rising, and it is linked to several risk factors. In this study, the incidence of GERD in a sample of the population was examined, along with the associated factors that may have an impact on it. The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) was included in a self-administered survey given to 490 participants in a cross-sectional study to help determine who was more likely to have GERD. The questionnaire collected data on demographic elements, health-related traits, and past GERD diagnoses. The findings revealed that 32.7% of the individuals had previously received a GERD diagnosis. Of the patients,17.1% had a GERD-Q score of 8 or above, which indicates a higher likelihood of having GERD. Participants who had previously been diagnosed with GERD had a noticeably greater incidence of GERD, and females had a higher incidence of GERD than males. The frequency of caffeine consumption was substantially correlated with the occurrence of GERD. Our study emphasizes the value of early GERD diagnosis and therapy to reduce problems and enhance the quality of life for those who are affected. According to our research, coffee use, gender, and prior GERD diagnoses are all linked to an increased risk of developing GERD. The GERD-Q is a trustworthy and proven tool for GERD diagnosis and might be used in clinical practice to recognize GERD patients and offer suitable treatment. Additional research is required to determine how additional risk variables affect the prevalence of GERD.

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.

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 < .001). On generalized linear model GERDQ scores and female gender positively correlated with EHAS (GERDQ, β = 2.254, P < .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.

Efficacy of endoscopic anterior fundoplication with a novel ultrasonic surgical endostapler for gastroesophageal reflux disease: Six-month results from a multicenter prospective trial.

Endoscopic therapy is an option for the treatment of refractory gastroesophageal reflux disease (GERD). We aimed to evaluate the efficacy and safety of transoral incisionless fundoplication with the Medigus ultrasonic surgical endostapler (MUSE™) for refractory GERD. Patients with 2 years of documented GERD symptoms and at least 6 months of proton-pump inhibitors (PPIs) therapy were enrolled in four medical centers from March 2017 to March 2019. The GERD health-related quality of life (HRQL) score, GERD questionnaire score, total acid exposure on esophageal pH probe monitoring, the gastroesophageal flap valve (GEFV), esophageal manometry, and PPIs dosage were compared between the pre- and post-MUSE procedure. All of the side effects were recorded. A reduction of at least 50% in the GERD-HRQL score was observed in 77.8% (42/54) patients. Most patients 74.1% (40/54) discontinued PPIs and 11.1% (6/54) reported a ≥50% dose reduction. The percentage of patients who had normalized acid exposure time after the procedure was 46.9% (23/49). The existence of hiatal hernia at baseline was negatively correlated with the curative effect. Mild pain was common and resolved within 48 h postprocedure. Serious complications were pneumoperitoneum (one case), mediastinal emphysema combined with pleural effusion (two cases). Endoscopic anterior fundoplication with MUSE was an effective treatment for refractory GERD, but still needs refinement and improvement in safety aspect. Esophageal hiatal hernia may affect the efficacy of MUSE. (www.chictr.org.cn, ChiCTR2000034350).

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.

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.

Mean Nocturnal Baseline Impedance and Post-reflux Swallow-induced Peristaltic Wave Index Could Identify Gastroesophageal Reflux Disease but pH-Impedance Metrics Alone Might Not Correlate With Proton Pump Inhibitor Response in Chinese Patients With Typical Reflux Symptoms.

Background/AimsLyon consensus differentiates acid exposure time (AET) as physiological, borderline, and pathological. Mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWi) are believed to increase diagnostic yield of gastroesophageal reflux disease (GERD) and correlate with symptom outcome of proton pump inhibitor (PPI) treatment. We aim to explore the clinical characteristics and the correlation of pH-impedance parameters with PPI response in Chinese patients with different AET levels.MethodsWe retrospectively investigated 177 patients with typical reflux symptoms who received esophageal function tests. The demographics, GERD questionnaire scores, the proportion of esophagitis and PPI responders, and manometric and pH-impedance parameters were compared among patients with AET < 4%, 4-6%, and > 6%. In patients with AET ≥ 4%, manometric and pH-impedance parameters were compared between PPI responders and non-responders.ResultsAmong 177 patients, 69 (39.0%) had AET 4-6%, and 53 (29.9%) had AET > 6%. The demographics, esophagogastric junction type, and occurrence of ineffective esophageal motility were similar between patients with AET 4-6% and > 6%, but different from AET < 4%. MNBI and PSPWi were different among different AET levels, but similar between PPI responders and non-responders in patients with AET ≥ 4%.ConclusionsIt is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients.

Herbal Medicine Hewei Jiangni Decoction Is Noninferior to Oral Omeprazole for the Treatment of Nonerosive Gastroesophageal Reflux Disease: A Randomized, Double-Blind, and Double-Dummy Controlled Trail.

Objectives Conventional approaches for patients with nonerosive gastroesophageal reflux disease (NERD) were not satisfactory. This study aimed to evaluate the effectiveness and mechanisms of Chinese herbal medicine Hewei Jiangni Decoction (HWJND) as a novel and promising regimen for NERD. Methods A total of 128 patients with NERD were randomly assigned to the Treatment group and Control group. The patients from the Treatment group were administered HWJND (81 g) plus dummy omeprazole (20 mg) daily for 8 weeks, and the others were given dummy HWJND granules (81 g) plus omeprazole (20 mg). The clinical efficacy was assessed using the gastroesophageal reflux disease questionnaire (GERD-Q) scale, patient reported outcomes (PRO) scale, and short form health survey 36 (SF-36) scale at week 4. Moreover, its pharmacological and molecular mechanisms were elucidated based on network pharmacology and molecular docking. Results Due to case shedding and other reasons, 109 patients, including 56 in the Treatment group and 53 in the Control group completed this study. Our results showed that HWJND significantly improved heartburn, regurgitation, epigastric pain, nausea, and sleep disturbance, which led to a significant reduction of GERD-Q scores in NERD patients. In addition, PRO scores of NERD patients with HWJND administration were improved, and sufficient relief of physical role, body pain, general health, social function, and mental health on the SF-36 scale was also observed in patients after HWJND treatment. We further showed that the curative effect of HWJND was close to that of omeprazole, except for the better improvement of general health and social function. What's more, the main active ingredients of HWJND included quercetin, beta-sitosterol, naringenin, baicalein, and kaempferol were retrieved, and the protective effects of HWJND against NERD may be closely related to targets such as TNF, IL6, IL1B, MMP9, CXCL8, and EGFR, which were mainly enriched in IL-17 signaling pathway and TNF signaling pathway. Conclusion Our findings demonstrate that HWJND is noninferior to oral omeprazole for the treatment of patients with NERD, plays a therapeutic role through multiple targets and diverse pathways, and holds promise for complementary and alternative therapy for the treatment of NERD. This trial is registered with http://www.chictr.org.cn, Chinese Clinical Trials Registry [ChiCTR2200055960].

Gerd-Q Score As Outcome Parameter Of Anterior vs. Posterior Peroral Endoscopical Myotomy in Acalasia Patient

Achalasia is an esophageal motility disorder which is characterized by relaxation failure of the lower esophageal sphincter and absence of distal esophageal peristalsis. The prevalence rate of achalasia is 10 cases per 100,000 population with dysphagia, regurgitation, chest pain, and weight loss as the main clinical manifestations. Target of treatment for achalasia is a decreased resting pressure in the lower esophageal sphincter and this can be achieved using peroral endoscopic myotomy (POEM). POEM can be performed using two therapeutic approaches: anterior and posterior. Complication that often occurs after POEM is Gastroesophageal Reflux Disease (GERD). GERD leads to symptoms and/or structural damage that affects the patient’s quality of life. The GERD questionnaire (GERD-Q) is a sensitive and non-invasive screening tool for diagnosing GERD. Based on the result analysis of this research that was conducted to assess the outcome of anterior and posterior POEM with the GERD-Q score parameter, there was no significant difference in scores between the anterior and posterior approaches.

Investigation of Reflux Characteristics in Outpatients of Otorhinolaryngology-Head and Neck Surgery by Age and Gender in the Chinese Population

To investigate the characteristics of patients with reflux diseases in the otorhinolaryngology-head and neck surgery clinics through the Reflux Symptom Scale-12 (RSS-12) and the Gastroesophageal Reflux Disease Questionnaire (GERD-Q). All included patients completed the RSS-12 and GERD-Q scales and were considered to have LPR with an RSS-12 score >11 and GERD with a GERD-Q score >7. Data were analyzed according to genders (male and female) and age (18-40, 41-60, and >60 years). A total of 977 patients were included. the mean RSS-12 and GERD-Q score were 11.32±21.34 and 6.31±1.21, and the positive rate of LPR and GERD were 28.76% and 8.90%, respectively. Males had a higher positive rate of LPR and GERD than females, and there were more males with LPR who also had GERD. Among those with both LPR and GERD, males had significantly higher ear-nose-throat (ENT) symptom scores such as hoarseness and excess throat mucus than females. However, females had significantly higher scores of gastrointestinal (GI) symptoms, mainly indigestion and abdominal pain, and elder patients (>60 years) had higher scores of ENT, GI, respiratory symptoms, as well as the impact of symptoms on quality of life than the young patients (18-40, and 41-60 years). Patients in the otorhinolaryngology-head and neck surgery clinics have different reflux characteristics by gender and age in the Chinese population. Males had more severe ENT-related symptoms of distress, while females had more complaints of GI symptoms. Older patients had higher scores for ENT, GI and respiratory symptoms.

Clinical efficacy of endoscopic antireflux mucosectomy vs. Stretta radiofrequency in the treatment of gastroesophageal reflux disease: a retrospective, single-center cohort study.

BackgroundCurrently, antireflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) are the most commonly used minimally invasive antireflux therapies. To date, there have not been any reports comparing ARMS and SRF. Our aim was to compare the clinical efficacies of these two therapeutic methods.MethodsWe analyzed data from gastroesophageal reflux disease (GERD) patients, including 39 who received ARMS treatment and 30 who received SRF treatment between January 2020 and May 2021. Symptom control, gastroesophageal reflux disease questionnaire (GERDQ) score, gastroesophageal reflux disease health-related quality of life (GERD-HRQL) score, proton pump inhibitor (PPI) withdrawal, and PPI reduction were analyzed and compared.ResultsAfter 6 months of follow-up, the results showed that both therapies were effective in improving symptoms and quality of life. No difference was found between the ARMS group and SRF group in GERDQ score, GERD-HRQL score, PPI withdrawal rate, or PPI reduction rate (P>0.05). There was no significant difference in the PPI withdrawal rate between the two therapies among patients with gastroesophageal flap valve (GEFV) grade II and grade III (P>0.05), but the PPI withdrawal rate in the ARMS group was significantly higher than that in the SRF group among patients with GEFV grade IV (P<0.05).ConclusionsThe clinical efficacies of ARMS and SRF 6 months postoperation were equivalent. The results showed that both ARMS and SRF treatment were acceptable for patients with GEFV grades II and III, while ARMS should be selected for patients with GEFV grade IV.

Objective ambulatory pH monitoring and subjective symptom assessment of gastroesophageal reflux disease show type of carbohydrate and type of fat matter.

Background:Rising prevalence of gastroesophageal reflux disease (GERD) in US Veterans is concurrent with increasing excess body weight.Objective:The objective of this cross-sectional study is to examine relationships between dietary macronutrients, gastrointestinal hormones, and GERD status.Methods:Ninety-eight veterans with overweight/obesity and empiric proton pump inhibitor (PPI) treatment were enrolled from the Tennessee Valley Healthcare System. Subjects had esophageal manometry and 24-h pH monitoring. Subjective symptoms were assessed with Gastroesophageal Reflux Disease Questionnaire (GERDQ) and Symptom Assessment Scale (GSAS). The primary outcomes, total acid exposure time (AET) and number of reflux episodes, enabled categorizing subjects as either pathologic GERD or inconclusive GERD. Data analysis included independent T-tests, Spearman Rho correlations, and multivariable linear regression modeling.Results:Higher intake of sugar-sweetened beverages (sugar-sweetened tea, soda, and fruit juice) associated with higher AET. Higher saturated-to-unsaturated fat intake is associated with higher AET and number of reflux episodes. Overall, sugar-sweetened beverage intake, saturated-to-unsaturated fat ratio, tomato-based food items, glucagon-like polypeptide 1 (GLP-1) level, time of first meal, and education status accounted for a significant amount of the variability in AET. Pathologic GERD subjects reported more heartburn (p = 0.006), regurgitation (p = 0.01), acid taste (0.001), and nausea severity (p = 0.04). GERDQ score associated with AET (r = 0.31, p = 0.005), but GSAS did not (r = 0.12, p = 0.28).Conclusion:Of the many foods and nutrients tested, the type (not amount) of carbohydrate (simple sugars) and the type (not amount) of fat (saturated vs unsaturated fat) consumed associated with objective and/or subjective GERD testing. These novel findings contribute to the evidence base guiding specific dietary recommendations in the clinical management of GERD.

Prevalence of Gastroesophageal Disease and Associated Risk Factors Among the Population in Al-Qunfudah.

Background and objectiveGastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases worldwide. It causes an unpleasant effect on patients' lives and may lead to serious complications resulting in a significant burden on healthcare systems. Despite being a common gastrointestinal disease, very few studies have been conducted on the condition in Saudi Arabia; and there has never been a study to estimate the prevalence of GERD in the Al-Qunfudah Governorate. In light of this, we conducted this study with an aim to assess the prevalence of GERD and its associated risk factors among the Al-Qunfudah population.MethodsA cross-sectional study was conducted in the Al-Qunfudah Governorate by using an online self-administrated questionnaire that was shared through social media during the first week of January 2021. The questionnaire consisted of a general section on sociodemographic data and a section on the diagnosis of GERD based on the validated gastroesophageal reflux disease questionnaire (GERD-Q). A total of 1,180 eligible participants responded to the questionnaire.ResultsNearly one-third (32.9%) of the study participants had GERD based on their reported symptoms and calculated scores (GERD-Q score ≥8). About 14.8% of the participants (175/1,180) reported that they had already been diagnosed with GERD before their participation in our survey. Regarding risk factors of GERD, about 35% reported experiencing psychological stress, 28.3% had a family member diagnosed with GERD, and 18.1% were smokers; 49.4% of the participants had their symptoms aggravated by consuming fatty or fried food and 46.7% by spicy food. One of the factors that helped to relieve GERD symptoms was avoiding symptom-aggravating food, as reported by more than half (50.7%) of the participants.ConclusionThe prevalence of GERD in the Al-Qunfudah population is high as the condition has affected one-third of the adult population. Our study confirms that male gender, age of 30 years or above, being overweight or obese, being married, smoking habit, use of non-steroidal anti-inflammatory drugs (NSAIDs), having psychological stress, being asthmatic, or having a family history of GERD are factors that significantly increase the likelihood of developing GERD. The reported risk factors include experiencing psychological stress, a family history of GERD, high BMI, and smoking.

The Association Between the Pattern of Electronic Cigarette Smoking and Gastroesophageal Reflux

Background: This study was aimed to investigate the proportion of gastroesophageal reflux (GER) among electronic cigarette (e-cig) smokers and its association with the pattern of e-cig smoking.Method: This cross-sectional study underwent among e-cig smokers community in Cirebon City, Jawa Barat, ranged from March to August 2020. Subjects were enrolled through consecutive sampling method. The data collection used survey containing the pattern of e-cig smoking and GER. The pattern of e-cig smoking included the duration of e-cig smoking and the amount of e-cig smoking. Gastroesophageal reflux consisted of GER-related symptoms (heartburn, regurgitation, and nocturnal symptom) and gastroesophageal reflux disease (GERD). GERD was defined as GERD questionnaire score cut-off 8. Data analysis used chi square test. This study has been approved by The Medical Research Ethics Committee, Faculty of Medicine, Universitas Swadaya Gunung Jati.Results: There were 273 respondents in this study. The proportion of heartburn was 6.6%, 10.3% for regurgitation, 3.7% for nocturnal symptom, and 5.5% for GERD. There was no association between duration of e-cig smoking and heartburn (p 0.681), regurgitation (p 0.568), nocturnal symptom (p 0.764), and GERD (p 0.113). There was no association between amount of e-cig smoking and heartburn (p 0.062), regurgitation (p 0.770), nocturnal symptom (p 0.985), and GERD (p 0.605).Conclusion: There was relatively low proportion of GER among e-cig smokers. There was no association between the pattern of e-cig smoking and GER in this study.

Predictive Factors of Gastroesophageal Reflux Disease Symptoms Following Open Sleeve Gastrectomy in Brazil Using Clinical Questionnaire.

To evaluate predictors of symptoms of gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) based on a clinical questionnaire. This is a cross-sectional study. We included all patients who underwent open SG between May 2013 and March 2017 in a single institution. Patients who could not be contacted or who did not want to participate were excluded. Clinical, demographic, and pre- and postoperative data were collected on medical records. Patients were contacted via telephone and inquired about GERD symptoms postoperatively. Symptoms were quantified using the GERD Questionnaire (GERDq). Patients were divided into three study groups according to GERDq score: asymptomatic (GERDq = 0), mildly symptomatic (GERDq ≤ 8), and severely symptomatic (GERDq > 8). Univariate analysis was performed using ANOVA, Kruskal-Wallis, Dunn, and chi-square tests. A logistic regression model was built for adjusted analysis of the data. One hundred eighty-nine patients were included. Mean age was 39.7 ± 10.71 years and 45.5% were female. Postoperative median follow-up period was 4.55 years (interquartile range 5.34-3.76). Mean GERDq score was 7.62 ± 10.17. Sixty-four patients were asymptomatic, 63 were mildly symptomatic, and 62 were severely symptomatic. The group of severely symptomatic patients showed a statistically lower preoperative weight when compared to the other groups (p = 0.049), but this association was not observed when analyzing preoperative BMI (p = 0.427). The other variables were not associated with postoperative GERD symptoms, both in univariate and adjusted analysis. No variables were statistically and clinically predictive of GERD occurrence or severity after SG. The pathophysiology of GERD is complex and further studies are needed to elucidate this condition.

Validation of the French version of the esophageal hypervigilance and anxiety scale

IntroductionAn esophageal hypervigilance and anxiety scale (EHAS) was developed in English to assess the psychological process in patients with esophageal disorders. The aim of the current study was to validate this scale in French. Patients and methodsPatients referred for esophageal high resolution manometry (HRM) were offered to fill out different questionnaires including EHAS, Eckart score and gastro-esophageal reflux disease-questionnaire (GERDQ) score. EHAS was translated in French by 2 French native speaker experts in esophageal motility. Patients were grouped according to the indications of HRM (dysphagia, reflux, other). The total EHAS score was calculated and compared between groups. The validation method used the assessment of internal consistency with Cronbach’s α and reliability with Guttman split-half reliability. ResultsAmong the 607 patients who accepted to fill out questionnaires, the EHAS questionnaire was completed and analyzable in 469 patients. The total score had an excellent internal consistency (Cronbach’s α = 0.91) and reliability (Guttman statistic = 0.86). EHAS score was not different between groups while Eckardt score was logically higher in patients with dysphagia than in others (p < 0.001) and GERDQ score was higher in patients with reflux than in those with dysphagia (p < 0.001). Despite different load on anxiety and hypervigilance scales, inter-item correlations and average scores did not differ between the original and the French EHAS. ConclusionEHAS is a valid questionnaire in French. It can be interpreted using the original EHAS score. Further studies are required to demonstrate the utility of this score in patients’ management.