Frequency and clinical implications of supraesophageal and dyspeptic symptoms in gastroesophageal reflux disease.

Abstract

OBJECTIVE:

We studied the frequency of supraesophageal and dyspeptic symptoms and their impact on the quality of life (QoL) and treatment response in patients with gastroesophageal reflux disease (GERD).

METHODS:

Multicenter, prospective, observational study of patients who consulted a gastroenterologist because of typical GERD symptoms. Upper digestive symptoms were assessed using direct interviews. The Short Form-12 and the Quality of Life in Reflux and Dyspepsia questionnaires were used to measure QoL. Patients were treated with proton pump inhibitors (PPIs).

RESULTS:

A total of 301 patients (58% men; mean age, 45 years) were included. Baseline symptoms were heartburn (99% of cases; nocturnal heartburn 78%), regurgitation (86%), both heartburn and regurgitation (85%), dyspeptic symptoms (91%; epigastric pain syndrome 20%, postprandial distress syndrome 4%, both 75%), and supraesophageal symptoms (58%). In 56% of cases of heartburn, 35% of regurgitation, and 34% of nocturnal heartburn, symptoms were severe or very severe. One in six patients had dysphagia. Supraesophageal and/or dyspeptic symptoms were associated with worse scores on the Short Form-12 and Quality of Life in Reflux and Dyspepsia instruments. After treatment, heartburn and regurgitation disappeared in 93 and 87% of the patients, respectively. The percentage of patients responding to PPI treatment was significantly higher (P<0.05) in those with heartburn than those without heartburn (96 vs. 86%) and in those with regurgitation than without regurgitation (95 vs. 83%), whereas no differences were observed in those with and without supraesophageal or dyspeptic symptoms.

CONCLUSION:

Patients with typical GERD symptoms (heartburn and/or regurgitation) very frequently have dyspeptic and supraesophageal manifestations, which are related to a worse QoL but unrelated to PPI response.

• Authors: Fermín Mearin, Julio Ponce, Marta Ponce, Agustín Balboa, Miguel A Gónzalez, Javier Zapardiel
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 24 Issue 6 Pg. 665-74 (Jun 2012) ISSN: 1473-5687 [Electronic] England
• PMID: 22330237 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Proton Pump Inhibitors

Topics

• Adult
• Aged
• Body Mass Index
• Dyspepsia (epidemiology, etiology, psychology)
• Female
• Gastroesophageal Reflux (complications, drug therapy, epidemiology, psychology)
• Heartburn (epidemiology, etiology, psychology)
• Humans
• Male
• Middle Aged
• Overweight (complications, epidemiology)
• Prospective Studies
• Proton Pump Inhibitors (therapeutic use)
• Psychometrics
• Quality of Life
• Risk Factors
• Severity of Illness Index
• Spain (epidemiology)
• Treatment Outcome