Prevalence Of Gastroesophageal Reflux Disease Research Articles

Natural history of gastroesophageal reflux in infancy: new data from a prospective cohort

BackgroundGastroesophageal reflux (GER) is common in infants. Gastroesophageal reflux disease (GERD) is defined as GER leading to troublesome symptoms that affect daily functioning and/or complications. This study is aimed at determining the prevalence and progression of GER and GERD in a cohort of healthy term infants from birth to 12 months old.MethodsWe conducted a prospective cohort study including all full-term living neonates born at Besançon Teaching Hospital, France. Parents completed a clinical report form and the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R) at 1, 3, 6, 10, and 12 months of age. GER was defined as score ≥ 1 to the first question with I-GERQ-R score < 16, and GERD as score ≥ 1 to the first question with I-GERQ-R score ≥ 16. Regurgitation was based on the answer to the first question of the I-GERQ-R as anything coming out of the mouth daily.Results157/347 births were included (83 boys). The prevalence of regurgitation at least once a day was 45.7% overall. In total: 72, 69, 56, 18, and 13% of infants regurgitated at least once a day at 1, 3, 6, 10, and 12 months of age, respectively. Physiological GER affected 53, 59, 51, 16, and 12% of infants; GERD, 19, 9, 5, 2, and 2%, respectively. Two risk factors were identified: family history of GER and exposure to passive smoking. Treatment included dietary modification (14%) and pharmacotherapy (5%).ConclusionPhysiological GER peaked at 3 months, GERD at 1 month. Most cases resolved on their own. GER and GERD are very common in the infant’s population and parents should be reassured/educated regarding symptoms, warning signs, and generally favorable prognosis. I-GERQ-R is useful to the clinical screening and follow up for GER and GERD.

Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis

Although gastro-oesophageal reflux disease (GORD) is a common medical complaint, there is currently no consensus on the global prevalence of GORD. The aim of this study was to conduct a systematic review and meta-analysis on GORD prevalence and risk factors at a global level. MEDLINE, EMBASE, CINAHL, Scopus, Cochrane library, and Google Scholar were systematically searched, without language restrictions, for studies on the prevalence and risk factors of GORD. Data were pooled using a random effects model (95% confidence interval), and the odds ratio and relative risk for each risk factor were calculated. Out of 34,355 search results, 96 records reporting the results from 102 studies fulfilled the inclusion criteria, representing 37 countries and all regions of the UN geoscheme. The global pooled prevalence of GORD was 13.98% and varied greatly according to region (12.88% in Latin America and the Caribbean to 19.55% in North America) and country (4.16% in China to 22.40% in Turkey). Using the United Nations 2017 Revision of World Population Prospects, the estimated number of individuals suffering from GORD globally is 1.03 billion. Multiple risk factors associated with a significant increase in the risk of GORD were also identified. This systematic review and meta-analysis revealed that although a substantial proportion (13.98%) of the global population suffers from GORD, there are significant variations between regions and countries. Risk factors for GORD were also identified which may allow clinicians to recognise individuals most at risk.

The Causes of Gastroesophageal Reflux after Laparoscopic Sleeve Gastrectomy: Quantitative Assessment of the Structure and Function of the Esophagogastric Junction by Magnetic Resonance Imaging and High-Resolution Manometry.

The incidence of de novo gastroesophageal reflux disease (GERD) after LSG is substantial. However, an objective correlation with the structural gastric and EGJ changes has not been demonstrated yet. We aimed to prospectively evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on the structure and function of the esophagogastric junction (EGJ) and stomach. Investigations were performed before and after > 50% reduction in excess body weight (6-12months after LSG). Subjects with GERD at baseline were excluded. Magnetic Resonance Imaging (MRI), high-resolution manometry (HRM), and ambulatory pH-impedance measurements were used to assess the structure and function of the EGJ and stomach before and after LSG. From 35 patients screened, 23 (66%) completed the study (age 36 ± 10years, BMI 42 ± 5kg/m2). Mean excess weight loss was 59 ± 18% after 7.1 ± 1.7-month follow-up. Esophageal acid exposure (2.4 (1.5-3.2) to 5.1 (2.8-7.3); p= 0.040 (normal < 4.0%)) and reflux events increased after surgery (57 ± 24 to 84 ± 38; p= 0.006 (normal < 80/day)). Esophageal motility was not altered by surgery; however, intrabdominal EGJ length and pressure were reduced (both p< 0.001); whereas the esophagogastric insertion angle (35° ± 11° to 51° ± 16°; p= 0.0004 (normal < 60°)) and esophageal opening diameter (16.9 ± 2.8mm to 18.0 ± 3.7mm; p= 0.029) were increased. The increase in reflux events correlated with changes in EGJ insertion angle (p= 0.010). Patients with > 80% reduction in gastric capacity (TGV) had the highest prevalence of symptomatic GERD. LSG has multiple effects on the EGJ and stomach that facilitate reflux. In particular, EGJ disruption as indicated by increased (more obtuse) esophagogastric insertion angle and small gastric capacity were associated with the risk of GERD after LSG. clinicaltrials.gov: NCT01980420.

Nutritional Deficiencies Associated with Gastroesophageal Reflux Disease (GERD) in Elderly/Older Adults

Introduction: Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder encountered in the elderly patient. GERD is one of the highly prevalent diseases seen in the clinical practice. In the elderly population, few studies have addressed the prevalence of GERD. It is estimated that 20-30% of the US population experience weekly symptoms of GERD, and two out of five people experience heartburn or acid regurgitation at least once a month. Methods: To ensure peer-review articles were used, the search engine, PubMed was utilized along with medical reference-related websites and US Department websites as well as professional organizations. Some medications used by older adults may promote acid reflux, prescription treatments include proton pump inhibitors (PPIs), coating agents, H2 blockers and over-the-counter medications that contain antacids or decreased dosages of the prescription strength H2 blockers and PPIs. Discussion: Decreased stomach acidity could be responsible for risk of nutrient deficiencies including vitamin B12 (cobalamin), vitamin C (ascorbate), calcium, iron and magnesium deficiencies or medications that are used to alleviate the symptoms of GERD may also be responsible for increasing the risk for deficiencies. The purpose of this review is to demonstrate and provide reasons why regular assessment, screening, testing, and/or clinically evaluating nutritional deficiencies common in older adults and relating to physical pathogenesis and/or drug treatments of GERD, should be added to the GERD treatment protocol for older adults.

Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study.

Type 2 diabetes (T2DM) is associated with gastroesophageal reflux disease (GERD) in the general population, but the relationship between these conditions in candidates for bariatric surgery is uncertain. We compared the prevalence of GERD and the association between GERD symptoms and esophagitis among bariatric candidates with and without T2DM. Cross-sectional study of baseline data from the Oseberg study in Norway. Both groups underwent gastroduodenoscopy and completed validated questionnaires: Gastrointestinal Symptom Rating Scale and Gastroesophageal Reflux Disease Questionnaire. Participants with T2DM underwent 24-h pH-metry. A total of 124 patients with T2DM, 81 women, mean (SD) age 48.6 (9.4) years and BMI 42.3 (5.5) kg/m2, and 64 patients without T2DM, 46 women, age 43.0 (11.0) years and BMI 43.0 (5.0) kg/m2, were included. The proportions of patients reporting GERD-symptoms were low (< 29%) and did not differ significantly between groups, while the proportions of patients with esophagitis were high both in the T2DM and non-T2DM group, 58% versus 47%, p = 0.16. The majority of patients with esophagitis did not have GERD-symptoms (68-80%). Further, 55% of the patients with T2DM had pathologic acid reflux. Among these, 71% also had erosive esophagitis, whereof 67% were asymptomatic. The prevalence of GERD was similar in bariatric patients with or without T2DM, and the proportion of patients with asymptomatic GERD was high independent of the presence or absence of T2DM. Accordingly, GERD may be underdiagnosed in patients not undergoing a preoperative endoscopy or acid reflux assessment. Clinical Trials.gov number NCT01778738.

The global, regional, and national burden of gastro-oesophageal reflux disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

SummaryBackgroundGastro-oesophageal reflux disease is a common chronic ailment that causes uncomfortable symptoms and increases the risk of oesophageal adenocarcinoma. We aimed to report the burden of gastro-oesophageal reflux disease in 195 countries and territories between 1990 and 2017, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017.MethodsWe did a systematic review to identify measurements of the prevalence of gastro-oesophageal reflux disease in geographically defined populations worldwide between 1990 and 2017. These estimates were analysed with DisMod-MR, a Bayesian mixed-effects meta-regression tool that incorporates predictive covariates and adjustments for differences in study design in a geographical cascade of models. Fitted values for broader geographical units inform prior distributions for finer geographical units. Prevalence was estimated for 195 countries and territories. Reports of the frequency and severity of symptoms among individuals with gastro-oesophageal reflux disease were used to estimate the prevalence of cases with no, mild to moderate, or severe to very severe symptoms at a given time; these estimates were multiplied by disability weights to estimate years lived with disability (YLD).FindingsData to estimate gastro-oesophageal reflux disease burden were scant, totalling 144 location-years (unique measurements from a year and location, regardless of whether a study reported them alongside measurements for other locations or years) of prevalence data. These came from six (86%) of seven GBD super-regions, 11 (52%) of 21 GBD regions, and 39 (20%) of 195 countries and territories. Mean estimates of age-standardised prevalence for all locations in 2017 ranged from 4408 cases per 100 000 population to 14 035 cases per 100 000 population. Age-standardised prevalence was highest (>11 000 cases per 100 000 population) in the USA, Italy, Greece, New Zealand, and several countries in Latin America and the Caribbean, north Africa and the Middle East, and eastern Europe; it was lowest (<7000 cases per 100 000 population) in the high-income Asia Pacific, east Asia, Iceland, France, Denmark, and Switzerland. Global prevalence peaked at ages 75–79 years, at 18 820 (95% uncertainty interval [95% UI] 13 770–24 000) cases per 100 000 population. Global age-standardised prevalence was stable between 1990 and 2017 (8791 [95% UI 7772–9834] cases per 100 000 population in 1990 and 8819 [7781–9863] cases per 100 000 population in 2017, percentage change 0·3% [–0·3 to 0·9]), but all-age prevalence increased by 18·1% (15·6–20·4) between 1990 and 2017, from 7859 (6905–8851) cases per 100 000 population in 1990 to 9283 (8189–10 400) cases per 100 000 population in 2017. YLDs increased by 67·1% (95% UI 63·5–70·3) between 1990 and 2017, from 3·60 million (1·93–6·12) in 1990 to 6·01 million (3·22–10·19) in 2017.InterpretationGastro-oesophageal reflux disease is common worldwide, although less so in much of eastern Asia. The stability of our global age-standardised prevalence estimates over time suggests that the epidemiology of the disease has not changed, but the estimates of all-age prevalence and YLDs, which increased between 1990 and 2017, suggest that the burden of gastro-oesophageal reflux disease is nonetheless increasing as a result of ageing and population growth.FundingBill & Melinda Gates Foundation.

Bariatric surgery and gastroesophageal reflux disease.

With the rapidly increasing prevalence of obesity globally, the practice of bariatric surgery is being adopted routinely to prevent the development of chronic conditions as well as some forms of cancers associated with obesity. Gastroesophageal reflux disease (GERD) is one of those chronic conditions. Furthermore, there is accumulating data that obesity is associated with complications related to longstanding GERD such as erosive esophagitis (EE), Barrett’s esophagus (BE), and esophageal adenocarcinoma (EAC). Central obesity, rather than body mass index (BMI), appears to be more closely associated with these complications. It should be expected, therefore, that weight loss procedures should result in improvement in GERD symptoms and its associated complications. However, in reality the different bariatric surgical procedures have unpredictable effects on an established GERD and may even produce GERD symptoms for the very first time (de novo). In this review, we explore the literature studying the effects of bariatric surgical operations on GERD. Roux-en-Y gastric bypass appears to have the most beneficial effect on GERD. On the other hand, laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding (LAGB) are linked with long-term increased prevalence of GERD. We argue that GERD is an extremely important preoperative consideration for any patient undergoing bariatric surgery and therefore should be thoroughly investigated objectively (with 24-hour pH study and high-resolution manometry) to select the most suitable bariatric procedure for patients for their long-term success.

Prevalence of gastroesophageal reflux disease: a population-based cross-sectional study in southern Chile.

BackgroundThis study assessed the prevalence of gastroesophageal reflux disease (GERD) in a general adult population from Temuco in southern Chile. The association of GERD with demographic variables was also examined.MethodsA cross-sectional study among the general population of Temuco in southern Chile was conducted in 2017, using a validated and reliable questionnaire for detecting GERD. The urban area of Temuco, with a population of 245,317 inhabitants (2002 census), was divided into four zones, which were representative of the socioeconomic sectors of the city. The sample size was estimated assuming a prevalence of 52.8%, an accuracy of 3.0%, a confidence level of 95.0%, and a design effect of 1.15. Area sampling was used to build clusters. The prevalence of GERD was determined and associated factors were studied by means of bivariate and multivariate analyses.ResultsA total of 1,069 subjects (47.9% women, median age 40 years) from the selected subareas were interviewed. The prevalence of GERD was 44.8%. The most frequently reported symptom was regurgitation (54.8%). One-third of subjects took medication to control symptoms and was considered ‘sick’ by the instrument, although >68% of them had never sought medical consultation. There was a significant association between GERD and age (P < 0.001) and female gender (P = 0.001).ConclusionsIn this population-based study, the prevalence of GERD was high (44.8%). GERD was associated with age and female gender.

The Relationship between Croup and Gastroesophageal Reflux: A Systematic Review and Meta-Analysis.

The mechanism by which recurrent croup occurs is unknown. Gastroesophageal reflux is commonly implicated, although this relationship is only loosely documented. We conducted a systematic review with a meta-analysis component to evaluate the relationship between recurrent croup and gastroesophageal reflux disease (GERD), and to assess for evidence of improvement in croup symptoms when treated. Systematic Review and Meta Analysis. We searched five separate databases. Studies were included if they discussed the relationship between croup and GERD in children, >5 subjects, and available in English. Literature retrieved was assessed according to pre-specified criteria. Retrieved articles were reviewed by two independent authors and decisions mediated by a third author. If there was a difference of opinion after first review, a second review was performed to obtain consensus. Heterogeneity was calculated and summarized in forest plots. Of 346 initial records, 15 met inclusion criteria. These were two retrospective cohort and 13 cross-sectional studies. Thirteen of 15 articles support an association between recurrent croup and GERD. Although heterogeneity is high among studies that reported prevalence of GERD, there is less uncertainty in results for improvement to recurrent croup after GERD treatment. Most studies lacked a control group and all carry a moderate-to-high risk of bias. There is limited evidence linking GERD to recurrent croup; Further research is needed to assess for causality as most studies are retrospective, lack a control group, and have a study design exposing them to bias. Patients treated with reflux medication appear to demonstrate a reduced incidence of croup symptoms. 1 Laryngoscope, 131:209-217, 2021.

Predictive Factors of Gastroesophageal Reflux Disease in Bariatric Surgery: a Controlled Trial Comparing Sleeve Gastrectomy with Gastric Bypass.

To evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity. Patients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery. Seventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) LRYGB. LSG patients had lower BMI (40.3 ± 4.0 kg/m2 vs. 42.7 ± 5.7 kg/m2; p = 0.041) and trend toward lower prevalence of GERD (20% vs. 40%; p = 0.061). One year after surgeries, GERD was more frequent in LSG patients (74% vs. 25%; p < 0.001) and all LSG patients with preoperative GERD continue to have GERD postoperatively. De novo GERD occurred in 19 of 28 (67.9%) of LSG patients and 4 of 24 (16.7%) patients treated with LRYGB (OR 10.6, 95%CI 2.78-40.1). Independent predictors for post-operative GERD were as follows: LSG (OR 12.3, 95%CI 2.9-52.5), preoperative esophagitis (OR 8.5, 95% CI 1.6-44.8), and age (OR 2.0, 95%CI 1.1-3.4). One year after surgery, persistent or de novo GERD were substantially more frequent in patients treated with LSG compared with LRYGB. LSG was the strongest predictor for GERD in our trial. Preoperative counseling and choice of bariatric surgical options must include a detailed assessment and discussion of GERD-related surgical outcomes.

Prevalence of gastro-esophageal reflux in diabetic patients at a tertiary hospital in Central Saudi Arabia

Objectives:To estimate the prevalence of gastro-esophageal reflux disease (GERD) among diabetic patients and to investigate GERD’s potential association with diabetic complications, and patients’ sociodemographic and clinical characteristics.Methods:This cross-sectional study used the GERD questionnaire (GerdQ) in 403 diabetic patients attending the outpatient clinics at King Khalid University Hospital, King Saud University Medical City, King Saud University; a tertiary hospital in Riyadh, Saudi Arabia, between January and February 2019. On the basis of a cutoff GerdQ score of 8, we distinguished GERD and non-GERD groups.Results:Gastro-esophageal reflux disease prevalence was 44.9%. Of the diabetic patients with GERD, 76.8% were female (p<0.001). Gastro-esophageal reflux disease patients were older (mean age: 55.27, p=0.038) and had a slightly higher body mass index (BMI) than non-GERD (32.04 versus, 30.20 p=0.006), respectively. Smokers in the GERD group were 1.7% versus 7.2% in the non-GERD group (p=0.007). Peripheral numbness (p=0.023) and nephropathy (p=0.041) were more prevalent in patients with GERD, while myocardial infarction was more prevalent in non-GERD subjects (p=0.038). On multi variable analysis, the only independent GERD risk factors were female gender (p=0.013) and age >65 years (p=0.007).Conclusion:Gastro-esophageal reflux disease prevalence in diabetic patients was 45%. Diabetic patients with GERD were more often female and older >65 years. None of the other tested factors (BMI, smoking status, diabetes mellitus duration, therapeutic plan, or diabetic complications) showed significant difference between GERD and non-GERD groups.

Does Sleeve Gastrectomy Expose the Distal Esophagus to Severe Reflux?: A Systematic Review and Meta-analysis.

The aim of this study was to appraise the prevalence of gastroesophageal reflux disease (GERD), esophagitis, and Barrett's esophagus (BE) after sleeve gastrectomy (SG) through a systematic review and meta-analysis. The precise prevalence of new-onset or worsening GERD after SG is controversial. Subsequent esophagitis and BE can be a serious unintended sequalae. Their postoperative prevalence remains unclear. A systematic literature search was performed to identify studies evaluating postoperative outcomes in primary SG for morbid obesity. The primary outcome was prevalence of GERD, esophagitis, and BE after SG. Meta-analysis was performed to calculate combined prevalence. A total of 46 studies totaling 10,718 patients were included. Meta-analysis found that the increase of postoperative GERD after sleeve (POGAS) was 19% and de novo reflux was 23%. The long-term prevalence of esophagitis was 28% and BE was 8%. Four percent of all patients required conversion to RYGB for severe reflux. The postoperative prevalence of GERD, esophagitis, and BE following SG is significant. Symptoms do not always correlate with the presence of pathology. As the surgical uptake of SG continues to increase, there is a need to ensure that surgical decision-making and the consent process for this procedure consider these long-term complications while also ensuring their postoperative surveillance through endoscopic and physiological approaches. The long-term outcomes of this commonly performed bariatric procedure should be considered alongside its weight loss and metabolic effects.

To study the prevalence of Gastroesophageal reflux disease in patients with airway obstructive disease

To study the prevalence of Gastroesophageal reflux disease in patients with airway obstructive disease

Prevalence and predictors of proton pump inhibitor partial response in gastroesophageal reflux disease in systemic sclerosis: a prospective study

Proton pump inhibitor (PPI) twice daily dosing is a standard therapy for gastroesophageal reflux disease (GERD) in systemic sclerosis (SSc) but there is no data on its response rate or the predictors of PPI-partial response GERD. Aims were to determine the prevalence of PPI-partial response GERD in SSc and to define its predictors. A prospective study was conducted in SSc patients with GERD. The patients were treated with omeprazole 20 mg bid for 4 weeks. The severity of symptom-grading by visual analogue scale (VAS) and frequency of symptoms by frequency scale for symptoms of GERD (FSSG) were assessed at baseline and 4 weeks after treatment. PPI-partial response GERD was defined as less than 50% improvement in the VAS for severity of symptom as well as acid reflux score by FSSG after treatment. According to the sample size calculation, 243 SSc-GERD patients were enrolled; of whom 166 (68.3%) had the diffuse cutaneous SSc. PPI-partial response GERD was found in 131 SSc patients (prevalence 53.9%; 95%CI 47.4–60.3). The multivariate analysis revealed that esophageal dysphagia was an only predictor the PPI-partial response GERD (OR 1.82; 95%CI 1.01–3.29) while neither SSc subset nor severity of skin tightness were significantly associated with PPI-partial response GERD. Half of the SSc patients were PPI-partial response GERD. Esophageal dysphagia was the only predictor of PPI-partial response GERD in SSc patients. Screening for dysphagia before starting GERD treatment is helpful for assessment the risk of PPI refractoriness GERD in SSc patients.

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Southwestern Saudi Arabia.

BackgroundGastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that has substantial health and economic consequences. Several modifiable risk factors are associated with GERD, hence we conducted the present study to assess the prevalence and risk factors of GERD in a previously understudied population of southwestern Saudi Arabia.MethodsA cross-sectional study was carried out to calculate the prevalence of GERD and assess its risk factors. A structured self-administered questionnaire was distributed on a random sample of 853 participants from Jazan region, Saudi Arabia. The questionnaire consisted of questions on the participants’ sociodemographic and lifestyle characteristics. The presence of GERD was detected using the GERD questionnaire (GerdQ). Data were analyzed using descriptive statistics and chi-square test, with a significance level of P < 0.05 or P < 0.01.ResultsThe study included 853 participants; 69.1% males and 30.9% females. The proportion of participants who scored >8 on the GerdQ (had GERD) was 32.2%. GERD was associated with age (P < 0.01), marital status (P < 0.01), employment status (P < 0.01), fast food intake (P < 0.01), analgesics use (P < 0.01), and smoking (P < 0.01). GERD was more common among Khat chewers compared to non-Khat chewers (P < 0.05) and showed a significant association with the frequency of Khat use.ConclusionThe results show a high prevalence of GERD in the general population of Southwestern Saudi Arabia. Several sociodemographic and lifestyle characteristics were associated with the disease.

Risk assessment of obstructive sleep apnea among gastroesophageal reflux disease patients in Taif, Saudi Arabia.

Background:Previous studies have reported the association between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA).Objectives:The aim of the present study was to assess the prevalence of GERD among Saudi population, and to determine the risk of OSA among those diagnosed with GERD in Taif city of Saudi Arabia.Materials and Methods:A cross-sectional online survey was done among 843 Saudi participants using a questionnaire by collecting demographic data, weight, height, blood group, and having a previous nose or throat surgery. The GERD questionnaire and the sleep apnea symptom index were used to determine GERD and OSA prevalence.Results:The prevalence of GERD and OSA was 17.6% and 2.4%, respectively. A significantly higher prevalence of GERD was found among males, those with age >50 years, employees and obese participants, and those having OSA. Participants with an age >50 years and males, had a significantly higher prevalence of OSA. Being a male and older age were predictors for GERD, and the presence of GERD was an independent predictors for OSA.Conclusion:Future population-based studies including a representative sample of the population should be done to confirm the revealed association between GERD and OSA. It is necessary to assess GERD in patients with OSA in clinical practice.

Prevalence of gastroesophageal reflux disease, gastroduodenal erosions and ulcers and their association with the family predisposition to peptic ulcer disease in Siberian schoolchildren

The aim is to study the prevalence of gastroesophageal reflux disease (GERD), gastroduodenal erosions and ulcers and their association with a family predisposition for ulcer disease in Siberian schoolchildren. Material and methods. We have examined schoolchildren aged 7–17 years in three regions of Siberia (Republic of Tyva, Evenkia and Buryatia) in localities identical to their socio-economic level. Data collected using a cross-sectional method using standardized questionnaires on the presence of gastroenterological complaints and information about ulcer disease of relatives in the 1st and 2nd generations in 1535 schoolchildren in Tuva, 790 in Buryatia and 1369 in Evenkia. Diagnosis of GERD was based on the presence of complaints of heartburn, in accordance with international consensus in the pediatric population. We performed gastroscopy randomly method in each region at schoolchildren with gastrointestinal complaints (283 children in Tyva, 110 in Buryatia, 205 in Evenkia). Results. There was an increase in the GERD frequency among Siberian children with anamnesis data on the presence of peptic ulcer in relatives (9.9 and 5.9 %, respectively, p = 0.0025). The most unfavorable situation has been observed in the population of schoolchildren of the Republic of Tuva (10.6 % with a burdened history and 9.3 % without it, p = 0.5389). We have not revealed the significant increase of gastroduodenal erosions and ulcers in children with a poor family history of peptic ulcer disease (12.6 and 10.4 %, respectively, p = 0.5263), including Tuva schoolchildren where they were more often detected. The GERD association with erosive ulcerative process in the mucous membrane of the stomach and duodenum was ambiguous and had population (regional) features in schoolchildren with a burdened family history of peptic ulcer disease. Conclusion. Siberian schoolchildren with a family predisposition to peptic ulcer disease have certain regional features in the association of gastroduodenal erosions and ulcers with GERD.

Antioxidant system in implementation of endotoxicosis syndrome in young persons with comorbidity of gastroesophageal reflux disease and autoimmune thyroiditis

Introduction. In recent years, there has been an increase in the prevalence of gastroesophageal reflux disease and autoimmune thyroiditis in young people. This is associated with a hereditary predisposition, viral diseases, which are often recorded in children's and adolescent groups, the unreasonable use of a large number of drugs, as well as the influence of various negative environmental factors, instability of the autonomic nervous system, eating disorders, the presence of bad habits, chronic stress and others. The aim of the work was to investigate the state of total antioxidant status and the content of biomarkers of the second phase of detoxification of xenobiotics - manganese superoxide dismutase and glutathione peroxidase in young people with gastroesophageal reflux disease and autoimmune thyroiditis. Materials and methods. To achieve this goal, 120 patients with a combined course of gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT) were examined, which made up the main group and two comparison groups: with isolated GERD (45 people) and AIT (42 patients). All patients were students of various universities and were between the ages of 18 and 25. Duration of the disease did not exceed 3 years. The total antioxidant status as an indicator of the first phase of defense and the levels of mitochondrial manganese superoxide dismutase and glutathione peroxidase – the second phase of antioxidant defense was determined. Results. The study showed that in all surveyed groups there was a decrease of total antioxidant status, which characterizes the first phase of the antioxidant defense system. Changes in the first phase of antioxidant defense affect the indicators of the second level of the system, which became the basis for studying the activity of mitochondrial manganese superoxide dismutase. Thus, the value of this indicator in all examined individuals exceeded the norm, which confirmed the inclusion of the second controlling phase of antioxidant system into the pathological process. At the same time, an increase inhibition of the glutathione defense link, the second phase of xenobiotic detoxification, were diagnosed. Conclusions. Negative changes occur in the enzyme system of the first line of antioxidant system in patients with GERD and AIT which may be the result of an unfavorable autoimmune background. Control over the work of antioxidant system moves to the second phase of the system, manifested by an increase in the content of mitochondrial manganese superoxide dismutase and inhibition of the activity of glutathione peroxidase in patients with a combination of GERD and AIT.

Prevalence of Gastroesophageal Reflux Disease And Its Correlates in Adults Residing in an Urban Resettlement Colony of East Delhi

Background: Gastroesophageal Reflux Disease (GERD) is known as a condition caused by abnormal reflux of gastric contents into the esophagus. Most common symptoms include heartburn (a burning sensation in the middle of the chest) and regurgitation (an upward moving sensation of stomach content). GERD is a distressing medical condition which is under reported. This study was carried out to study the associated risk factors of GERD.Objective: The primary objective of the study was to determine the prevalence of GERD among adults residing in an urban resettlement colony of East Delhi. The secondary objective was to identify the risk factors associated with it.Methods: It was a cross sectional descriptive study conducted in Nand Nagri, a resettlement colony in East Delhi from November 2016 to April 2018. The study population comprised of 300 adults (18 and above).For assessment of GERD, Questionnaire for Epidemiology of symptomatic GERD was used.Results: The mean age of the study participants was 47.70 years. The prevalence of GERD among study participants was found to be 14.0%. On applying binary logistic regression to find out the predictors of GERD among study participants, female gender, BMI more than or equal to 25, smokers, having comorbid illness, consuming high amount of spices and more than 4 cups of tea or coffee were found to be significant predictors.Conclusion: The prevalence of GERD observed in the study was 14.0%. Significant predictors of GERD were female gender, BMI more than or equal to 25, smokers, having comorbid illness, consuming high amount of spices and consuming more than 4 cups of tea or coffee.

Prevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms

There are few data on the prevalence of gastroesophageal reflux disease (GERD) in the United States. We performed a population-based study to determine the prevalence of GERD symptoms and persistent GERD symptoms despite use of proton pump inhibitors (PPIs). We conducted the National Gastrointestinal Survey in 2015 using MyGiHealth, an app that guides participants through National Institutes of Health gastrointestinal Patient-Reported Outcomes Measurement Information System surveys. Primary outcomes were prevalence of GERD symptoms in the past and persistence of GERD symptoms (heartburn or regurgitation 2 or more days in past week) among participants taking PPIs. Population weights were applied to the data and multivariable regression was used to adjust for confounding. Among 71,812 participants, 32,878 (44.1%) reported having had GERD symptoms in the past and 23,039 (30.9%) reported having GERD symptoms in the past week. We also found that 35.1% of those who had experienced GERD symptoms were currently on therapy (55.2% on PPIs, 24.3% on histamine-2 receptor blockers, and 24.4% on antacids). Among 3229 participants taking daily PPIs, 54.1% had persistent GERD symptoms. Younger individuals, women, Latino individuals, and participants with irritable bowel syndrome or Crohn's disease were more likely to have continued symptoms, even when taking PPIs. Using a population-based survey, we found GERD symptoms to be common: 2 of 5 participants have had GERD symptoms in the past and 1 of 3 had symptoms in the past week. We also found that half of PPI users have persistent symptoms. Given the significant effect of GERD on quality of life, further research and development of new therapies are needed for patients with PPI-refractory GERD symptoms.