Risk Factors For Reflux Research Articles

Dietary risk factors and therapy outcomes of swallowing-related problems in laryngopharyngeal reflux: patients\u2019 perspectives

BackgroundThis was a prospective cohort that included 60 gastro-esophageal reflux disorder patients with suspected laryngopharyngeal reflux-related symptoms (e.g., sore throat, throat clearing, globus sensation, cough, dysphonia, and dysphagia). The diagnosis was confirmed using history taking, clinical laryngoscopic examination, and upper endoscopy guided by the Reflux Symptom Index (RSI). Patients were treated with proton pump inhibitors and prokinetics for 12 weeks. The aim of the current study was to explore the dietary risk factors in laryngopharyngeal reflux patients and to assess the response to therapy on swallowing-related problems by comparing the baseline pre-treatment and post-treatment values of RSI and Dysphagia Handicap index (DHI).ResultsAnalysis of data regarding the role of diet as a risk factor for reflux revealed that 33 patients (55%) are eating meat, 56 patients (93.3%) eating fat, 45 patients (75%) eating sweet, 55 patients (91.7%) eating spicy food, 52 patients (96.7%) eating fried food, 34 patients (56.7%) drinking tea, 51 patients (85%) eating big meals, 21 patients (35%) drinking fruit juices, 54 patients (90%) eating sour foods, 51 patients (85%) eating citrus fruits, and 22 patients (36.7%) smokers. There was a statistically significant decrease in Reflux Symptom Index scores and an increase of Dysphagia Handicap Index scores after 12 weeks on proton pump inhibitors and prokinetics.ConclusionDifferent dietary factors were present in LPR patients. A short period of empiric anti-reflux treatment has a significant improving effect on Reflux Symptom Index and Dysphagia Handicap Index scores from baseline to 12 weeks post-treatment. Further research is needed to investigate longer times of treatment for the complete resolution of symptoms.

High prevalence of chronic venous disease among health care workers in the United States

BackgroundHealth care workers spend extended times standing and walking short distances and are at risk for development of chronic venous insufficiency (CVI). We conducted a hospital-wide venous screening program designed to measure the prevalence of and risk factors for clinical manifestations of CVI and ultrasound evidence of venous reflux or obstruction in health care workers. We also determined their risk for deep venous thrombosis (DVT). MethodsFree venous screening and education were offered to all hospital employees; the program started in April 2016, and results are presented from the first year. Demographics, medical history, and use of compression stockings were recorded. A physical examination determined the clinical class of the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification for clinical disease, and an ultrasound test evaluated for reflux or obstruction in the common femoral vein, popliteal vein, and saphenofemoral junction. The Caprini score was recorded to evaluate risk of DVT. Descriptive statistics were reported, and logistic regression was used for multivariate analysis of risk factors. ResultsWe enrolled 636 participants (1272 legs); 93.0% were women. The median age was 42 years (interquartile range, 31-52 years), mean body mass index was 29.2 ± 6.6 kg/m2, and most participants were white (49.1%) or African American (39.5%); 18% reported having hypertension, 7.1% had diabetes, and 6.1% were current smokers. The majority reported occasional leg pain (72.7%) and evening leg swelling (42.3%). Only 2.7% used daily compression stockings. Clinical evidence of CVI was present in at least one leg in 69.1% (C1, 49.0%; C2, 17.7%; C3, 1.9%; C4, 0.2%; C5, 0.2%). Venous reflux was present in at least one leg in 82.1%; obstruction was rare (0.2%). Reflux in either the superficial (saphenofemoral junction) or the deep (femoral or popliteal) venous system was present in the majority (71.0%) of patients with CVI (clinical class ≥C1). Reflux and white race were risk factors for clinical disease; clinical disease, age, female sex, and white race were risk factors for reflux. On the basis of the Caprini score, 14.1% of participants were in the highest risk category for DVT when experiencing a high-risk situation (including 2.2% with history of DVT). ConclusionsPrevalence of clinical CVI and venous reflux is high among health care workers despite a low frequency of cardiovascular comorbidities. Increased awareness about CVI and DVT and preventive strategies for venous disease must be instituted in this high-risk cohort.

A study of the symptoms of gastro-esophageal reflux disease and associated risk factors among the rural school children of Veleru India

International Journal of Medicine and Public Health,2013,3,4,324.DOI:10.4103/2230-8598.123510Published:October2013Type:Original ArticleA study of the symptoms of gastro-esophageal reflux disease and associated risk factors among the rural school children of Veleru IndiaGunda Jahnavi, Satya Ranjan Patra, and Sarah E. Singh Gunda Jahnavi, Satya Ranjan Patra1, Sarah E. Singh2 Departments of Community Medicine, and 1Surgery, Madha Medical College and Research Institute, Kovur, Thandalam, Chennai, Tamil Nadu, India, 2BA (Biological Scienes) Binghamton University, 4400 Vestal Parkway East, Vestal, NY 13850, USA Abstract:Background: Prevalence of gastro-esophageal reflux disease (GERD) in all ages has shown an upward trend over the past decades. The reasons for this increase are ill-understood. The data in the pediatric population is limited. Recent studies have linked childhood GERD to adult GERD. This study was conducted to assess the symptoms, risk factors of GERD among the schoolchildren residing in a rural area. Aims: The aim of this study was to find out the prevalence of GERD risk factors among the school children aged 8-17 years and to find any association between body mass indexes, meal pattern and sleep disturbances related to GERD. Materials and Methods: We did a cross-sectional study on 380 school children of 4th-10th standard from 4 schools of Veleru, the Rural Health Center attached to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences. The questionnaire consisted of questions for reflux symptoms, meal pattern and sleep disturbances. Results: The symptoms of reflux like abdominal pain was reported in 7%, heartburn in 1.3%, regurgitation in 2.4%, vomiting in 2.9%, difficulty in swallowing in 2.1%, sore taste in mouth in 0.8% of the children. The risk-factors for reflux like caffeinated drinks were found in 45.3%, very spicy food in 12.1%, heavy meals in 2.4% of the children. Sleep disturbance was seen in 33.4% of the children. Obesity was present in 0.6% of the children. Conclusion: School children should be informed about the symptoms and risk factors of GERD so that healthy dietary habits can be developed at a young age and GERD can be prevented. Keywords:Dietary habits, Gastro-esophageal reflux disease, School childrenView:PDF (383 KB)

Is an occupation with vocal load a risk factor for laryngopharyngeal reflux: a prospective, multicentre, multivariate comparative study

To compare the prevalence of laryngopharyngeal reflux in choristers, teachers and control subjects without vocal load at work and to determine the risk factors for laryngopharyngeal reflux. A prospective, multicentre, multivariate comparative study. One hundred and nineteen singers from four professional choirs, seventy teachers from four schools and 111 control subjects with an occupation without vocal load. All participants completed a questionnaire about their dietary habits, height and weight, presence of stress, smoking and allergies, including the nine-item Reflux Symptom Index. The groups of choristers, teachers and the controls were compared with each other with regard to their sex, age, dietary habits, body-mass index, Reflux Symptom Index score and other factors affecting voice quality. The subjects from all three groups with suspected laryngopharyngeal reflux were compared with the subjects without it. The relationship between the Reflux Symptom Index score and the possible risk factors for reflux was estimated. The results showed significantly higher Reflux Symptom Index scores in the choristers than in the teachers and the controls (mean scores, 7.86 versus 6.33, P = 0.044; 7.86 versus 4.80, P = 0.000, respectively), but the number of subjects with suspected laryngopharyngeal reflux (Reflux Symptom Index score >13) did not differ significantly between the groups. The choristers were significantly more often treated for laryngopharyngeal reflux than the teachers and the controls (41%, 17% and 28%, respectively). The occupation chorister and frequently experiencing stress were the only factors that influenced the total Reflux Symptom Index score. Laryngopharyngeal reflux affects the choristers more often than the teachers or the control subjects without vocal load at work. These results suggest that singing as the main professional activity can notably contribute to the development of the reflux. Vocal load without singing is probably not an important aetiological factor for laryngopharyngeal reflux. The extraoesophageal symptoms affecting voice require treatment for laryngopharyngeal reflux and proper dietary habits especially in the group with high voice quality demands.

The prevalence of gastroesophageal reflux disease among hospital employees

Quantitative estimate of the actual prevalence of the gastroesophageal reflux disease (GERD) is difficult to obtain because most of the patients with heartburn have intermittent symptoms. The aim of this study was to assess the frequency of typical and atypical symptoms suggesting GERD to investigate the association of habits and social conditions reported to lead to reflux in the employees of hospital. A total of 2037 collected forms were assessed. The prevalence of GERD was found to be 21.7% (442). The prevalence of symptoms other than heartburn in employees with and without GERD symptoms were 6.6% versus 3.4% (P < 0.05) for asthma, 27.6% versus 8.3% (P < 0.001) for night cough, 50% versus 19.5% (P < 0.001) for noncardiac chest pain. Dyspeptic complaints were found to be significantly higher among GERD patients (P < 0.001). By multiple logistic regression analysis, female gender (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.03-1.60, P = 0.027), non-steroidal anti-inflammatory drug medication (OR 1.29, 95% CI 1.03-1.60, P = 0.021) and body mass index over 30 (OR 2.26, 95% CI 1.60-3.18, P < 0.001) were independent risk factors associated with GERD symptoms. GERD is a common health problem in Turkey, and its prevalence is similar to that of Western populations with different symptom profiles. Female gender, non-steroidal anti-inflammatory drug, and body mass index >30 kg/m(2) were independent risk factors associated with GERD symptoms. Age, alcohol, coffee, tea, and tobacco smoking do not seem to be risk factors for reflux.

PTU-186 Exogenous NSAID exposure increases transcriptional expression of the 5-lipoxygenase pathway in normal squamous tissue, but not in Barrett's metaplasia: an ex vivo study of oesophageal biopsy specimens

IntroductionBarrett's oesophagus (BO) is a premalignant condition for oesophageal adenocarcinoma, an increasingly common malignancy with poor survival. The prostanoids and leukotrienes are lipid inflammatory mediators derived from a common precursor...

Risk factors associated with symptoms of gastroesophageal reflux

BACKGROUND: Although patients with gastroesophageal reflux are often instructed to change their lifestyle, population-based data on the risk factors for reflux in the United States are lacking. METHODS: We performed a cross-sectional study in an age- and gender-stratified random sample of the population of Olmsted County, Minnesota. Residents aged 25 to 74 years were mailed a valid self-report questionnaire that measured reflux symptoms and potential risk factors. Logistic regression was used to estimate the odds ratios (OR) with 95% confidence intervals (CI) for reflux symptoms (heartburn or acid regurgitation) associated with potential risk factors. RESULTS: Overall, 1,524 (72%) of 2,118 eligible subjects responded. A body mass index >30 kg/m 2 (OR = 2.8; CI, 1.7 to 4.5), reporting an immediate family member with heartburn or disease of the esophagus or stomach (OR = 2.6; CI, 1.8 to 3.7), a past history of smoking (OR = 1.6; CI, 1.1 to 2.3), consuming more than seven drinks per week (OR = 1.9; CI, 1.1 to 3.3), and a higher psychosomatic symptom checklist score (OR per 5 units = 1.4; CI, 1.3 to 1.6) were independently associated with frequent (at least weekly) reflux symptoms. CONCLUSION: Obesity is a strong risk factor for gastroesophageal reflux, although the value of weight reduction remains to be proven. That family history was also a risk factor suggests that there may be a genetic component to the disorder.

Gastroesophageal reflux during spontaneous respiration with the laryngeal mask airway.

To determine the incidence of gastroesophageal reflux during general anesthesia with the Laryngeal Mask Airway (LMA). Twenty unpremedicated patients with no risk factors for reflux having day case anesthesia were included. Type of surgery was Orthopedic (n=8), General (n=7) and Gynecological (n=5). The average duration of anesthesia was 38.1 min, range 12 - 71 min. Anesthesia was induced with 1-2 microg x kg(-1) fentanyl and 2-3 mg x kg(-1) propofol and maintained with oxygen 33%, nitrous oxide 66% and isoflurane 1% (end-tidal). Ventilation by hand was performed until spontaneous respiration resumed. To facilitate surgery, 13 patients were placed in the supine and seven in the lithotomy positions. Two pH-sensitive electrodes were used to identify reflux. One was placed in the oesophagus 20 cm from the anterior nares to detect esophageal reflux and the other was placed through the bars of the LMA to detect refluxing material around the LMA. Esophageal reflux occurred in 12 patients (60%), in five of the 13 in the supine position and in all patients in the lithotomy position. The LMA electrode detected a decrease in pH in four cases (20%), all in the lithotomy position. The incidence reflux in the lithotomy and supine positions was different (Exact Probability test; P = 0.01). This study suggests that the lithotomy position predisposes patients to a higher risk of aspiration than the supine position when using a LMA.