Prevalence Of Gastroesophageal Reflux Disease Symptoms Research Articles

Prevalence and risk factors of gastroesophageal reflux disease symptoms in Mazandaran, North of Iran: A Tabari cohort study.

Gastro-esophageal reflux disease (GERD) is a very common complaint. It is a major health concern and there is paucity of information about the epidemiology of the disease and its risk factors in Iran, especially Mazandaran province (North of Iran). This study aimed at investigating the prevalence of regurgitation and the factors associated with this condition in Tabari cohort study. This was a cross-sectional study that analyzed data from Tabari cohort study. Information including the presence and frequency of heartburn and regurgitation, demographic characteristics, socioeconomic status, occupational history, history of chronic illnesses, history of alcohol and cigarette consumption were recorded. The prevalence of GERD symptoms were 27.6% (20.4% in men, and 32.4% in women, p=0.0001). The frequency of typical symptoms was significantly higher in women than that in men. The risk of developing GERD symptoms were 1.7 times higher in women (p=0.0001). The highest prevalence of GERD symptoms was found in urban areas (41.8%, p=0.0001), in people with low educational levels (48%, p=0.0001), and in participants with history of depression symptoms (36.2%, p=0.0001). The prevalence of GERD symptoms was significantly high in individuals with higher BMI (29.5%, p=0.006), greater waist to hip ratio (29.1%, p=0.0001, p=0.0001), and high waist circumference (31.7%, p=0.0001). This study showed gender, region of residence, educational level, and depression symptoms as the main risk factors for developing GERD symptoms.

Gastroesophageal reflux disease in Sri Lanka: An island-wide epidemiological survey assessing the prevalence and associated factors.

Gastroesophageal reflux disease (GERD) is commonly encountered in clinical practice in Sri Lanka. However, its prevalence in Sri Lanka is unknown. Our objective was to study the island-wide prevalence of GERD symptoms in Sri Lanka and its associated factors. A total of 1200 individuals aged 18-70 years (male: female 1: 1.16, mean age 42.7 years [SD 14.4 years]). were recruited from all 25 districts of the country, using stratified random sampling. An interviewer-administered, country-validated questionnaire was used to assess the GERD symptom prevalence and associated factors. Weight, height, waist, and hip circumference were measured. Heartburn and/or regurgitation at least once a week, an internationally used criterion for probable GERD was used to diagnose GERD. In this study, GERD symptom prevalence was 25.3% (male 42.1% and female 57.9%). Factors independently associated with GERD were inadequate sleep, snacking at midnight, sleeping within two hours of consuming a meal, skipping breakfast, increased mental stress, and certain medications used such as statins, and antihypertensive medications (p<0.001, univariate and logistic regression analysis). 38.4% of the study population have been using medication for heartburn and regurgitation in the past 3 months and 19.8% were on proton pump inhibitors. To conclude, the prevalence of GERD symptoms in Sri Lanka (25.3%) is higher than its estimated global prevalence of 13.8%. Several meal-related lifestyle habits, mental stress, and the use of some medications are significantly associated with GERD, indicating the importance of lifestyle modification and stress reduction in its management.

Gastroesophageal reflux disease in bronchial asthma: What we need to know?

Gastroesophageal reflux disease (GERD) is most common disease with variable presentation from asymptomatic to frank symptomatic disease having impact on various respiratory disease such as cough, bronchitis, bronchial asthma, chronic obstructive pulmonary disease, and interstitial lung diseases. GERD is defined by retrograde reflux of gastric contents to the esophagus leading to various signs and symptoms that range from heartburn/ regurgitation to the development of extraesophageal respiratory syndromes like asthma. Bronchial asthma and GERD are more common diseases and usually reported more frequently as “two side sides of same coin.” GERD has been associated with a causal link for asthma, worsening of asthma control, one of the causes for refractory asthma, and a main factor in asthma cases with recurrent asthma exacerbation. Asthma itself and medicines used for the treatment of asthma are associated with GERD, worsening of GERD and one of the causes for refractory GERD. However, asthmatics have been found to have a much greater prevalence of GERD symptoms than the general population. There remains debate regarding the underlying physiologic mechanism of this relationship and whether treatment of GERD actually translates into improved asthma outcomes. The clinical prevalence of the two conditions in many patients cannot be ignored, and multiple theories highlighting plausible pathogenic explanations for these associations have been described. The treatment of symptomatic GERD in patients with asthma is important to control the underlying GERD and should be undertaken based on current guidelines for the treatment of the GERD.

Exploring the Incidence and Associated Risk Factors of Barrett's Esophagus in African Americans: A Retrospective Study.

The prevalence of Barrett's esophagus (BE) in African Americans (AA) is uncertain. However, several potential risk factors, includes family history, male sex, ethnicity, chronic heartburn and acid reflux, age over 60, current or past smoking, and obesity are associated with BE. The aim of this study is to determine the incidence of BE in AA patients who underwent Esophageal Gastro Endoscopy (EGD). Medical and demographic data of 1,253 AA patients with various symptoms, including BE, Esophageal adenocarcinoma (EAC), esophageal squamous adenocarcinoma (SCC), hiatal hernia, H. pylori infection, Gastro-Esophageal Reflux Disease (GERD), Gastritis, and esophagitis, were collected from January 2004 to December 2014 at Howard University Hospital. Among the 1,253 patients, the median age was 61 and 49% were male out of the total. The frequencies of EAC (p= 0.05), and SCC (p= 0.002) were significantly high in males, along with SCC frequency significantly increased with older age (p<0.001). Furthermore, esophageal polyps with hiatal hernia (p=0.008) and H. pylori (p=<0.001) were found to be associated with esophagitis, and its presence may contribute to the development of BE. The findings highlighted the high prevalence of GERD symptoms and pathologic gastritis along with EAC was less common than SCC and both types of esophageal cancer were associated with male gender and older age whereas, H. pylori infection was identified as a risk factor for pathologic gastritis in AA. Overall data emphasize the need for extensive research, increased awareness, diagnosis, and management of GERD, gastritis, and related conditions to uncover the underlying mechanisms and factors contributing to these conditions in the AA population.

High Prevalence of Gastroesophageal Reflux Symptoms in Patients with both Acute and Nonacute Cough

Background and Aim: Gastro esophageal reflux disease (GERD) affects more than 30% of the Asian population, and its symptoms are common. The high prevalence of atrophic gastritis in the Pakistani population is exacerbated by gastro esophageal reflux disease. The present study aims was to assess the high prevalence of gastro esophageal reflux symptoms in patients with both acute and no acute cough. Materials and Methods: This cross-sectional study was conducted on 426 consecutive patients who attended the General Medicine and Emergency department of Sheikh Khalifa bin Zayed Hospital Rawalakot and Avicenna Hospital, Lahore from February 2021 to July 2021. Informed consent in written form was taken from all the patients. Patients with partial gastrectomy previous history and user of antagonist H2-receptor, steroids, proton pump inhibitor (PPI), and other inflammatory drugs two months prior to the investigation were excluded. Helsinki Declaration was utilized for this study with ethical approval taken from the hospital ethics committee. SPSS version 24 was used for data analysis. Results: Of the total 426 patients, GERD diagnosed patients were 248 (58.2%) and 178 (41.8%) had respiratory symptoms. The prevalence of GERD symptoms was higher in respiratory symptoms patients compared to without respiratory symptoms patients (p-value=0.05). Out of 178respiratory symptoms patients, GERD symptoms were present in 71 (39.9%) of acute cough while 107 (60.1%) of non-acute cough while 86 (34.7%) of 248 had no respiratory symptoms. The GERD development has no significant association with respiratory symptoms duration, however, patients having respiratory symptoms are at substantially elevated risk for GERD development. Conclusion: Our study found that respiratory symptoms patients are considerably more likely to develop GERD. GERD prevalence was similar in both acute and non-acute cough patients, implying that the presence of respiratory diseases is associated with the development of GERD regardless of the duration of respiratory symptoms. Keywords: Gastro esophageal reflux; Acute cough; Respiratory symptoms

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.

Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children: A Systematic Review.

Gastroesophageal reflux disease (GERD) is defined as gastroesophageal reflux causing troublesome symptoms or complications. In this study we reviewed the literature regarding the prevalence of GERD symptoms in infants and children. Databases of PubMed, EMBASE, and Cochrane were systematically searched from inception to June 26, 2018. English-written studies based on birth cohort, school-based, or general population samples of ≥50 children aged 0 to 21 years were included. Convenience samples were excluded. In total, 3581 unique studies were found, of which 25 studies (11 in infants and 14 in children) were included with data on the prevalence of GERD symptoms comprising a total population of 487,969 children. In infants (0-18 months), GERD symptoms are present in more than a quarter of infants on a daily basis and show a steady decline in frequency with almost complete disappearance of symptoms at the age of 12 months. In children older than 18 months, GERD symptoms show large variation in prevalence between studies (range 0%-38% of study population) and overall, are present in >10% and in 25% on respectively a weekly and monthly basis. Of the risk factors assessed, higher body mass index and the use of alcohol and tobacco were associated with higher GERD symptom prevalence. This systematic review demonstrates that the reported prevalence of GERD symptoms varies considerably, depending on method of data collection and criteria used to define symptoms. Nevertheless, the high reported prevalence rates support better investment of resources and educational campaigns focused on prevention.

Systematic Endoscopy 5Years After Sleeve Gastrectomy Results in a High Rate of Barrett's Esophagus: Results of a Multicenter Study.

Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG). The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy. Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study. From January 2017 to June 2018, each center during scheduled postoperative evaluation after surgery asked a minimum 10 consecutive patients, which had performed SG at least 5years before and with no evidence of BE preoperatively, to undergo another upper GI endoscopy. Ninety (66 F) consecutive patients were enrolled. The mean follow-up was 78 ± 15months, and the mean total body weight loss was 25 ± 12%. The prevalence of BE was 18.8% with no significant difference among centers. Weight loss failure was significantly associated with BE (p < 0.01). The prevalence of GERD symptoms, erosive esophagitis, and the usage of PPIs increased from 22%, 10%, and 22% before the SG to 76%, 41%, and 52% at the time of follow-up, respectively (p < 0.05). This multicenter study show a high rate of BE at least 5years after SG. Weight loss failure was significantly associated with BE. We suggest to provide systematic endoscopy in these patients to rule out this condition.

Study of the prevalence of gastroesophageal reflux symptoms and the role of each in relation to the GERD Impact Scale, based on a population of patients admitted for laparoscopic surgery compared to a control group.

IntroductionGastroesophageal reflux disease (GERD), demonstrated to impair quality of life (QoL), appears to show significant variation in its prevalence. Estimation of the prevalence is difficult. When defined as at least weekly heartburn and/or acid regurgitation, the prevalence reported in Asia is 2.5–27.6%, in Europe 23.7% and in the US 28.8%.AimThe study evaluates the prevalence of GERD symptoms in the assessment of the GERD Impact Scale (GERD-IS) in two age groups of patients.Material and methodsEvaluation of the prevalence of GERD symptoms with the GERD Impact Scale survey in two groups of patients: younger and older. A total of 2,649 surveys were rated. Statistical analysis was performed using the data analysis software system Statistica version 10.0 and Microsoft Excel.ResultsAccording to this study the symptoms of GERD included in GERD-IS in northern Poland vary from 0.9–2.4% as daily sensations to 18.9–40.5% occurring sometimes. Individuals with hiatal hernia (HH) were significantly older than those without HH. HH was significantly more frequent in males than females.ConclusionsEstimation of the prevalence of GERD is difficult, because the medications are widely available and people use them without any consultation. They do not recognize the symptoms as a disease whose treatment can also be surgical. Our analysis shows that the prevalence of symptoms of GERD in northern Poland is as high as 5%. Hence further investigation should be performed and people’s awareness should be raised.

Laparoscopic Sleeve Gastrectomy: Endoscopic Findings and Gastroesophageal Reflux Symptoms at 18-Month Follow-Up.

Laparoscopic sleeve gastrectomy (LSG) has shown excellent results in terms of weight loss and resolution of comorbidities. Despite that, the effect of LSG on gastroesophageal reflux disease (GERD) is still a controversial topic. Our objective was to evaluate the presence of gastroesophageal reflux symptoms, erosive esophagitis (EE), and hiatal hernia (HH) in obese patients undergoing LSG. Prospective observational study. LSG patients were studied before and at 18-month follow-up. Demographics, anthropometrics, status of comorbidities, perioperative data, GERD symptoms, and esophagogastroduodenoscopy (EGD) findings were evaluated. Between June 2012 and July 2014, 285 patients underwent LSG. Pre- and postoperative data were available in 109 patients; therefore, they were included in the study. There were 72 women (66%), age 40 ± 9 years. Preoperative body mass index (BMI) was 47.8 ± 16 kg/m2. At 18-month follow-up, body mass index and percentage excess weight loss were 29.3 ± 6 kg/m2 and 64% ± 9.4%, respectively. Resolution/improvement of comorbidities was as follows: diabetes 73%, hypertension 57.5%, and obstructive sleep apnea 89%. GERD symptoms increased from 33% to 44% (P = no statistical significance), EE from 20.1% (100% grade A) to 33.9% (74% grade A) (P < .001), and HH from 22% to 34.8% (P < .001). Postoperative findings on symptomatic patients were as follows: EE was found in 64.5%, HH in 23%, while 12.5% had normal EGD. There was a significant association between manifestation of GERD symptoms and the presence of EE on EGD (P < .05). Symptoms de novo were observed in 36.9% of patients, EE in 28.7%, and HH in 16.4%. Complication rate was 3.5%; there was no mortality. The prevalence of GERD symptoms, EE, and HH was increased after LSG. At 18-month follow-up, severity of esophagitis was mild, the majority of them being Grade A esophagitis. There was good correlation between manifestation of GERD symptoms and the presence of EE on EGD.

Prevalence of GERD Symptoms in Healthy High School Students

Introduction: Gastroesophageal reflux disease (GERD) is common in adults. Population based studies on adolescent GERD are limited. GERD symptoms in adolescents may be associated with food allergies, asthma, cigarette smoking or stress among other possible associations. The GERD-HRQL questionnaire has been shown to be a validated screening tool for GERD symptoms and severity. The aim of this study was to determine the prevalence of GERD in healthy high school students and its relationship to gender, BMI and type of school. Methods: The GERD-HRQL questionnaire was distributed to all high school students at two schools in the DFW area; one public and one private school. All students were in the 9th to 12th grade. Students were included in the anonymous survey if they returned the questionnaire. Data collected included demographics, height, and weight in addition to the survey questions. Utilization of statistical analysis on GERD-HQRL Questionnaire responses. Results: Completed surveys were returned by 287 students with 138 from the private school and 149 from the public school. The breakdown of the student group by gender was 160 females (56%) and 127 males (44%) and by race was 138 Whites (48%), 35 Blacks (12%), 41 Hispanics (14%), 42 Asians (15%), 28 mixed race (10%) and 3 with ethnicity left blank. The median age was 17 and median BMI was 22.1 with a range of 14.4 to 43.4. On the GERD-HRQL question regarding the severity of the heartburn, 69 students (24%) indicated some degree of heartburn. The majority of these students indicated their heartburn was not occurring daily and was either not bothersome or only somewhat bothersome, 30 (10%) and 24 students (8.4%), respectively. Fifteen students (5%) indicated were either bothersome daily, interfered with daily activities, or were incapacitating. A higher percentage of students with a BMI ≥25 reported GERD symptoms compared to those with BMI < 25, 56% and 28%, respectively. There was no relationship identified between GERD symptoms and gender, race or type of school. Evaluation for the presence of GERD symptoms revealed that 97 students (34%) had at least 1 symptom. Students indicating ≥3, ≥4, or ≥5 GERD symptoms were 30(10%), 24 (8%) and 9 (3%), respectively. Regarding current use of a medication for heartburn 19 students (7%) answered that they were taking a heartburn medication. Conclusion: The GERD-HRQL questionnaire was useful in identifying high school students with more severe GERD symptoms with a prevalence of 8%. The only characteristic that was identified as related to an increased the risk of GERD symptoms was a higher BMI. Once adolescents have been identified with GERD symptoms, the GERD-HRQL questionnaire can be used to monitor changes when treatment is initiated.

Presentation and Epidemiology of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal disorder in the United States, and leads to substantial morbidity, though associated mortality is rare. The prevalence of GERD symptoms appeared to increase until 1999. Risk factors for complications of GERD include advanced age, male sex, white race, abdominal obesity, andtobacco use. Most patients with GERD present with heartburn and effortless regurgitation. Coexistent dysphagia is considered an alarm symptom, prompting evaluation. There is substantial overlap between symptoms of GERD and those of eosinophilic esophagitis, functional dyspepsia, and gastroparesis, posing a challenge for patient management.

Prevalence of Gastroesophageal Reflux Disease and Its Risk Factors In Rural Area

Background: Prevalence of gastroesophageal reflux disease (GERD) is escalating in Asia. The present study aimed toinvestigate the prevalence of GERD symptoms as well as potential risk factors associated with GERD in residents in a rural area in Jakarta. Method: The study population consisted of subjects who aged 20 years or more and lived in rural area Kebon Bawang-Tanjung Priok, Jakarta. A self-administered questionnaire based on earlier validated questionnaire (GERDQ) was given. The questionnaire consisted of demographic characteristic, self and environment sanitary, social and past illness history, and the symptoms score for GERD. Total score for GERD’s symptoms score was 18, with a score of at least 8 was considered to have symptomatic GERD.Results: The questionnaire was completed in 90 subjects. Of the 90 subjects, 12 (13.3%) had GERDQ score ≥ 8 which was the cut-off for definingpresence of GERD. On both univariate and multivariate analysis, age 50 years old (OR = 6.33; 95% CI 1.1-35.6), handwashing habit before eating (OR = 6.93; 95% CI 1.1-43.8), and raw/tap water (OR = 10.28; 95% CI 0.8-130) were significantly associated with the presence of GERD.Conclusion: Prevalence of GERD was high (13.3%) in rural area in Jakarta. Age 50 years old, handwashing habit before eating, and raw/tap waterwere risk factors for GERD in this population.

Emerging Gastrointestinal and Liver Diseases in Asia Pacific: Implications to Health Care in the Region (World Gastroenterology Organization: Asian Pacific Association of Gastroenterology Distinguished Global Lecture 2015).

Colorectal cancer (CRC), gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), and nonalcoholic fatty liver disease are considered important emerging diseases in the Asia Pacific (AP) region. The incidence rate of CRC is the highest among gastrointestinal cancers in the region surpassing that of gastric cancer. However, population CRC screening is limited by availability of adequate health resources and financing. GERD is a highly prevalent disease in AP with the prevalence of GERD symptoms and reflux esophagitis reported to be increasing. The usage of proton pump inhibitors has also been reported to be high. The incidence and prevalence of IBD is not as high as in the west but is now an increasingly recognizable disease in the AP region. Being a complicated disease, IBD will pose a huge financial burden with the increasing use of expensive biological drugs. In tandem with the exponential increase in obesity and diabetes mellitus in AP, nonalcoholic fatty liver disease will become the most important liver disease in the region in the coming years. These emerging diseases reflect the continued fast-paced socioeconomic development in the region with marked lifestyle changes and increasing affluence.

Impact of Laparoscopic Sleeve Gastrectomy on Gastro Esophageal Reflux Disease

Introduction: Although laparoscopic sleeve gastrectomy (LSG) is an effective treatment for morbid obesity, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Although improvement of GERD symptoms following LSG has been reported in some studies, others have shown a 9–34.6 % increase in the prevalence of GERD symptoms during the first year following LSG. Aim: This study was aiming to evaluate the changes of GERD symptoms and erosive esophagitis (EE) in morbidly obese patients who underwent LSG. Patients and methods: Pre-and post-operative details of forty morbidly obese patients (body mass index (BMI) more than 40 kg/m2 or 35 kg/m2 with other comorbidities) with and without GERD who underwent laparoscopic sleeve gastrectomy and were followed up in Ain Shams University hospitals between September 2014 and May 2016 were recorded. Results: After surgery, significant decreases were reported in mean body mass index (44.3±3.8 vs. 36.5±5.3 kg/m2). Conversely, an insignificant increase was observed in the prevalence and severity of GERD symptoms and EE after LSG. 1 patient (20%) developed denovo symptomatic GERD within the 6 months follow-up. Conclusion: Although LSG can achieve significant weight loss and improvement of comorbidities in severely obese patients, the prevalence and severity of GERD symptoms and EE increase after the operation mandates that it should be carefully investigated pre-operatively and other bariatric surgery options should be considered.

Gastroesophageal reflux disease symptoms in the Greek general population: prevalence and risk factors

Background and aimsPopulation-based data regarding the prevalence of gastroesophageal reflux disease (GERD) in Greece are very poor. This study estimated the prevalence of GERD symptoms and their risk factors in the Greek adult population.MethodsA self-administered questionnaire was answered by a randomly selected population of 340 subjects. The question regarding “heartburn, chest pain, indigestion, or stomach acid coming up” as included in the Reflux Symptom Index was used for prevalence assessment.ResultsThe monthly prevalence of GERD symptoms was found to be 52.0% in the Greek general population, with no statistically significant difference between the two sexes (P>0.05). The age group of 65–79 years showed a higher prevalence rate of GERD. Symptom severity was found to be mild (59.3%) or moderate (27.1%). The number of cigarettes smoked daily (but not smoking duration) as well as the number of alcoholic drinks consumed daily (but not the duration of alcohol drinking) were found to be related to GERD symptoms. No reported concomitant disease or medication was found to be related with GERD symptoms.ConclusionThe prevalence of GERD symptoms in the Greek general population was found to be 52.0%. Tobacco smoking and alcohol drinking but not concomitant disease or medications were found to be related with GERD symptoms.

Racial Differences in the Relationships Between Gastroesophageal Reflux Disease (GERD), Dietary Macronutrients, and Insulin Resistance in Obese Women

Introduction: GERD, which occurs in 20-30% of U.S. adults, has a strong relationship with obesity. Insulin resistance, a consequence of adiposity induced loss of tissue sensitivity to the action of insulin, has also been associated with GERD. Excess dietary fat intake is thought to promote adiposity and insulin resistance. Recent evidence suggests a role for dietary carbohydrates. We examined relationships between GERD symptoms, medication use, dietary macronutrients, and insulin resistance in obese women. We hypothesized that: a) GERD would be associated with dietary carbohydrate more than dietary fat intake; and b) there would be differences in the relationships between GERD, dietary carbohydrate load, and insulin resistance between European American (EA) and African American (AA) obese women. Methods: 100 EA and 43 AA obese (BMI 30-39.9) women were enrolled in a high fat diet intervention and evaluated at baseline and at weeks 9 and 16 by 24-hour diet recalls, body composition, and fasting glucose and insulin. They were matched for ht, wt, BMI, %body fat, dietary energy and macronutrient intake. GERD was determined by weekly report of symptoms and medication use. Results: At baseline, 30% of EA women and 14% of AA women had GERD (P = 0.04). Thus, EA race was a strong predictor for having GERD (P = 0.03). In EA women, dietary total carbohydrate intake (r = 0.34, P < 0.001), added sugars (r = 0.30, P = 0.005) and glycemic load (r = 0.34, P = 0.001) were associated with GERD. Of the sugars, sucrose intake was most strongly associated with GERD (r = 0.33, P = 0.001). Dietary total fat was not significantly associated with GERD. In AA women, GERD was not significantly associated with dietary carbohydrate or fat intake. GERD (r = 0.30, P = 0.004) and dietary carbohydrates (r = 0.40, P < 0.001) were associated with insulin resistance (HOMA-IR score) in EA women, but not AA women. Conclusion: We found a difference by race in obese women in the prevalence of GERD symptoms and medication use. We found racial differences in the relationships between GERD and dietary carbohydrate intake. We detected a racial difference in the relationship between GERD, dietary carbohydrates and insulin resistance. These data suggest that dietary interventions targeting GERD need to be tailored to population subgroup. While reducing dietary carbohydrates, and particularly sugars like sucrose, may be beneficial for treating GERD symptoms in EA women, other dietary strategies may be more beneficial for AA women.

Prevalence of gastroesophageal reflux disease symptoms and effects of esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis.

The prevalence of gastroesophageal reflux disease (GERD) symptoms has not been investigated in patients on maintenance hemodialysis in Japan, and few studies have reported the effect of proton pump inhibitors (PPIs) in hemodialysis patients with GERD symptoms. Here, we investigated the prevalence of GERD symptoms and the effects of the PPI esomeprazole on the quality of life related to reflux and dyspepsia in patients on maintenance hemodialysis. This was a cross-sectional/cohort study of hemodialysis outpatients implemented in 10 Japanese medical facilities from October 2012 to March 2014. The trial was registered in the UMIN Clinical Trial Registry (UMIN000009124). Forty-one of 385 patients (11%) reported GERD symptoms on the Global Overall Symptom (GOS) questionnaire. Multivariate logistic regression analysis identified the independent prognostic factors for GERD symptoms as a history of gastric ulcer and use of sevelamer hydrochloride or calcium polystyrene sulfonate. Participants with GERD symptoms completed the Quality of Life in Reflux and Dyspepsia, Japanese version (QOLRAD-J) questionnaire and were assigned to receive 4-week esomeprazole treatment (20 mg/day). This PPI therapy significantly improved all QOLRAD-J domains in the full analysis set (n = 28) and improved the GERD symptoms listed in the GOS questionnaire. Significantly impaired disease-specific quality of life (QOL) in the QOLRAD-J domains was observed in 44.4-74.1% of patients who had symptoms before treatment. The mean GOS and QOLRAD-J scores correlated significantly. Therapy with 20 mg/day esomeprazole appears to be efficacious for improving disease-specific QOL and GERD symptoms in Japanese patients on maintenance hemodialysis.

Nonalcoholic Fatty Liver Disease Increases Risk for Gastroesophageal Reflux Symptoms

Nonalcoholic fatty liver disease (NAFLD) is now recognized as a leading cause of liver dysfunction. Gastroesophageal reflux disease (GERD) is a common disorder causing symptoms that often impair patients' quality of life. In recent years, the prevalence of both these diseases has increased, partially overlapping the rise of metabolic disorders. We investigated whether a relation does exist between NAFLD and GERD symptoms. Cross-sectional study among 206 outpatients diagnosed with NAFLD and 183 controls. We collected clinical and laboratory data, assessed severity and frequency of GERD symptoms and the esophageal endoscopic pattern. The prevalence of GERD symptoms was higher in NAFLD patients than controls (61.2 vs. 27.9%, p < 0.001). We found a positive association between NAFLD and the experiencing of heartburn, regurgitation and belching. GERD symptoms were related to body mass index (BMI) and metabolic syndrome (MetS); a strong association persisted after adjustment for all the covariates (adjusted OR 3.49, 95 CI% 2.24-5.44, p < 0.001). Our data show that the prevalence of GERD typical symptoms is higher in patients with NAFLD. GERD was associated with higher BMI and MetS, but not with age and diabetes type 2. NAFLD remained strongly associated with GERD, independently of a coexisting MetS status. Consistent with these findings, MetS can be considered a shared background, but cannot completely explain this correlation. We suggest NAFLD as an independent risk factor for GERD symptoms.

Prevalence and determinants of gastroesophageal reflux symptoms in adolescents

Gastroesophageal reflux disease (GERD) is common in adults, and there are increasing secular trends in adult GERD morbidity in many countries. However, population-based study on adolescent GERD was very limited. The specific aims of the study were to explore the prevalence and determinant of GERD symptoms in adolescents. A population-based association study was performed on 1828 students aged 13-16 years from four public junior high schools in Taiwan. The presences of symptoms of GERD, asthma and food allergy, demographic characteristics, and health behaviors were obtained by structured questionnaires. Complete information of symptoms of GERD and asthma were available for 1745 (95.5%) students. The cumulative and 3-month prevalence rates of GERD symptoms were 20.5% and 8.9%, respectively. Multivariate-adjusted odds ratio of having experienced GERD symptoms were 1.53 (95% confidence interval [CI]: 1.18-1.98) for ever smoking, 1.52 (95% CI: 1.12-2.26) for bi-ethnicity, 1.70 (95% CI: 1.26-2.29) for food allergy, and 3.59 (95% CI: 2.69-4.82) and 2.43 (95% CI: 1.67-3.53) for having asthma attacks within or more than 1 year before, respectively. Similar results were found for 3-month prevalence. The study showed that GERD symptoms were frequent in junior high school students in Taiwan. Food allergy, asthma, and cigarette smoking were independently correlated with the prevalence of GERD symptoms. Psychosocial factors associated with bi-ethnic family may contribute to its development.