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Prevalence of Extraesophageal Symptoms in Patients With Gastroesophageal Reflux Disease: A Multicenter Questionnaire-based Study in Korea

  • Min, Yang Won (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Seong Woo (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jun Haeng (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Hang Lak (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Oh Young (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Park, Jae Myung (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Choi, Myung-Gyu (Department of Internal Medicine, College of Medicine, The Catholic University of Korea) ;
  • Rhee, Poong-Lyul (Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2013.05.06
  • Accepted : 2013.08.04
  • Published : 2014.01.30

Abstract

Background/Aims Many patients with gastroesophageal reflux disease (GERD) also present with extraesophageal symptoms (EESs). This study sought to determine the prevalence of concomitant EESs and to evaluate quality of life (QOL) impairment in a Korean population with GERD. Methods This questionnaire-based study was carried out from 64 hospitals in Korea between October 2008 and March 2009. Patients with typical GERD symptoms of heartburn or acid regurgitation were recruited for study. Participants filled out questionnaire consisting of GerdQ questions and EES questions. All participants underwent endoscopy and were divided into patients with erosive reflux disease (ERD) and with non-erosive reflux disease (NERD). Results A total of 1,712 patients were included in this study. Of these, 697 (40.7%) patients had ERD and 1,015 (59.3%) NERD. The prevalence of EES was 90.3%. The most prevalent EES was epigastric burning (73.2%), followed by globus (51.8%), chest pain (48.4%), cough (32.0%), hoarseness (24.2%) and wheezing (17.3%). Individual EES was more prevalent in patients with ERD than in those with NERD. Regarding QOL, 701 patients (41.0%) had sleep disturbance and 676 (37.7%) had taken additional over-the-counter medication for heartburn and/or regurgitation, which were more prevalent in patients with ERD than in those with NERD (49.5% vs. 35.1% and 45.8% vs. 32.2%, respectively; all P < 0.001). Conclusions The prevalence of EES is high in Korean patients with symptomatic GERD. Individual EES is more prevalent in patients with ERD than in those with NERD. QOL impairment is observed less frequently than previous studies.

Keywords

Acknowledgement

Supported by : AstraZeneca Korea

References

  1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-1920. https://doi.org/10.1111/j.1572-0241.2006.00630.x
  2. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005;54:710-717. https://doi.org/10.1136/gut.2004.051821
  3. Wong BC, Kinoshita Y. Systematic review on epidemiology of gastroesophageal reflux disease in Asia. Clin Gastroenterol Hepatol 2006;4:398-407. https://doi.org/10.1016/j.cgh.2005.10.011
  4. Bai Y, Du Y, Zou D, et al. Gastroesophageal Reflux Disease Questionnaire (GerdQ) in real-world practice: a national multicenter survey on 8065 patients. J Gastroenterol Hepatol 2013;28:626-631. https://doi.org/10.1111/jgh.12125
  5. Cho YK, Kim GH, Kim JH, et al. [Diagnosis of gastroesophageal reflux disease: a systematic review.] Korean J Gastroenterol 2010;55:279-295. [Korean] https://doi.org/10.4166/kjg.2010.55.5.279
  6. Havemann BD, Henderson CA, El-Serag HB. The association between gastro-oesophageal reflux disease and asthma: a systematic review. Gut 2007;56:1654-1664. https://doi.org/10.1136/gut.2007.122465
  7. el-Serag HB, Sonnenberg A. Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans. Gastroenterology 1997;113:755-760. https://doi.org/10.1016/S0016-5085(97)70168-9
  8. Gislason T, Janson C, Vermeire P, et al. Respiratory symptoms and nocturnal gastroesophageal reflux: a population-based study of young adults in three European countries. Chest 2002;121:158-163. https://doi.org/10.1378/chest.121.1.158
  9. Jaspersen D, Kulig M, Labenz J, et al. Prevalence of extra-oesophageal manifestations in gastro-oesophageal reflux disease: an analysis based on the ProGERD Study. Aliment Pharmacol Ther 2003;17:1515-1520. https://doi.org/10.1046/j.1365-2036.2003.01606.x
  10. Ours TM, Kavuru MS, Schilz RJ, Richter JE. A prospective evaluation of esophageal testing and a double-blind, randomized study of omeprazole in a diagnostic and therapeutic algorithm for chronic cough. Am J Gastroenterol 1999;94:3131-3138. https://doi.org/10.1111/j.1572-0241.1999.01504.x
  11. Field SK, Sutherland LR. Does medical antireflux therapy improve asthma in asthmatics with gastroesophageal reflux?: a critical review of the literature. Chest 1998;114:275-283. https://doi.org/10.1378/chest.114.1.275
  12. Fass R, Fennerty MB, Vakil N. Nonerosive reflux disease - current concepts and dilemmas. Am J Gastroenterol 2001;96:303-314.
  13. Hom C, Vaezi MF. Extraesophageal manifestations of gastroesophageal reflux disease. Gastroenterol Clin North Am 2013;42:71-91. https://doi.org/10.1016/j.gtc.2012.11.004
  14. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology 1997;112:1448-1456. https://doi.org/10.1016/S0016-5085(97)70025-8
  15. Lee SH, Choi MG, Park SH, et al. [The clinical spectrum of gastroesophageal reflux disease in Korea.] Korean J Gastrointest Motil 2000;6:1-10. [Korean]
  16. Ing AJ, Ngu MC, Breslin AB. Chronic persistent cough and gastro-oesophageal reflux. Thorax 1991;46:479-483. https://doi.org/10.1136/thx.46.7.479
  17. Waring JP, Lacayo L, Hunter J, Katz E, Suwak B. Chronic cough and hoarseness in patients with severe gastroesophageal reflux disease. Diagnosis and response to therapy. Dig Dis Sci 1995;40:1093-1097. https://doi.org/10.1007/BF02064205
  18. Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther 2009;30:1030-1038. https://doi.org/10.1111/j.1365-2036.2009.04142.x
  19. Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996;111:85-92. https://doi.org/10.1053/gast.1996.v111.pm8698230
  20. Sugawa T, Fujiwara Y, Okuyama M, et al. [Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.] Nihon Rinsho 2007;65:946-950. [Japanese]
  21. Fock KM, Talley NJ, Fass R, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: update. J Gastroenterol Hepatol 2008;23:8-22.
  22. Yi CH, Liu TT, Chen CL. Atypical symptoms in patients with gastroesophageal reflux disease. J Neurogastroenterol Motil 2012;18:278-283. https://doi.org/10.5056/jnm.2012.18.3.278
  23. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology 2006;130:1466-1479. https://doi.org/10.1053/j.gastro.2005.11.059
  24. Quigley EM, Lacy BE. Overlap of functional dyspepsia and GERD - diagnostic and treatment implications. Nat Rev Gastroenterol Hepatol 2013;10:175-186. https://doi.org/10.1038/nrgastro.2012.253
  25. Räihä I, Hietanen E, Sourander L. Symptoms of gastro-oesophageal reflux disease in elderly people. Age Ageing 1991;20:365-370. https://doi.org/10.1093/ageing/20.5.365
  26. Tack J, Becher A, Mulligan C, Johnson DA. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on healthrelated quality of life. Aliment Pharmacol Ther 2012;35:1257-1266. https://doi.org/10.1111/j.1365-2036.2012.05086.x
  27. Gerson LB, Fass R. A systematic review of the definitions, prevalence, and response to treatment of nocturnal gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2009;7:372-378. https://doi.org/10.1016/j.cgh.2008.11.021
  28. Shaker R, Castell DO, Schoenfeld PS, Spechler SJ. Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. Am J Gastroenterol 2003;98:1487-1493. https://doi.org/10.1111/j.1572-0241.2003.07531.x
  29. Yi CH, Hu CT, Chen CL. Sleep dysfunction in patients with GERD: erosive versus nonerosive reflux disease. Am J Med Sci 2007;334:168-170. https://doi.org/10.1097/MAJ.0b013e318141f4a5

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