Gastroesophageal reflux disease prevalence in the city of Sivas

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.

Colonization of Helicobacter pylori in the oral cavity - an endless controversy?

Helicobacter pylori is associated with chronic gastritis, gastric or duodenal ulcers, and gastric cancer. Since the oral cavity is the entry port and the first component of the gastrointestinal system, the oral cavity has been discussed as a potential reservoir of H. pylori. Accordingly, a potential oral-oral transmission route of H. pylori raises the question concerning whether close contact such as kissing or sharing a meal can cause the transmission of H. pylori. Therefore, this topic has been investigated in many studies, applying different techniques for detection of H. pylori from oral samples, i.e. molecular techniques, immunological or biochemical methods and traditional culture techniques. While molecular, immunological or biochemical methods usually yield high detection rates, there is no definitive evidence that H. pylori has ever been isolated from the oral cavity. The specificity of those methods may be limited due to potential cross-reactivity, especially with H. pylori-like microorganisms such as Campylobacter spp. Furthermore, the influence of gastroesophageal reflux has not been investigated so far. This review aims to summarize and critically discuss previous studies investigating the potential colonization of H. pylori in the oral cavity and suggest novel research directions for targeting this critical research question.

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

Background

This 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.

Methods

A 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.

Results

A 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).

Conclusions

In this population-based study, the prevalence of GERD was high (44.8%). GERD was associated with age and female gender.

Fiberoptic Endoscopic Evaluation of Swallowing in Patients with Type 2 Diabetes Who Have Self-Reported Swallowing Difficulties

INTRODUCTION

People with diabetes frequently have gastrointestinal problems and related deglutition disorders.

OBJECTIVE

The aims of the present study are to determine the symptomatic swallowing complaints and to evaluate the functionality of oropharyngeal swallowing in patients with type 2 diabetes mellitus (T2DM) by using the Turkish Eating Assessment Tool-10 (T-EAT-10) and fiberoptic endoscopic evaluation of swallowing (FEES).

METHODS

In this descriptive cross-sectional study, the T-EAT-10 questionnaire was completed by 121 patients with diabetes, and FEES was planned for each individual whose baseline score of the T-EAT-10 was ≥3. Before swallowing trials via samples of nectar-thick consistency, laryngeal sensation and severity of secretion in the hypopharynx were observed. While the swallowing safety was determined using the Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale was used to assess the swallowing efficiency.

RESULTS

Of the total participants, 22.3% (n = 27) were found to have abnormal swallowing function (T-EAT-10 ≥3), 27.3% (n = 33) had concomitant neuropathy and 28.1% (n = 34) mentioned a reflux complaint. The results of the multivariate linear regression analysis exposed that the T-EAT-10 score was significantly associated with neuropathy (r = 3.763, p < 0.001) and reflux complaint (r = 2.254, p = 0.031). Of the total FEES-tested subjects (n = 20), 95% (n = 19) had a safe swallowing function (PAS = 1). However, diminished laryngeal sensation, increased secretion and presence of residue revealed that patients with T2DM who have self-reported swallowing difficulties have reduced swallowing efficiency.

CONCLUSIONS

This study has demonstrated that almost 1 out of 4 T2DM patients reported to have swallowing-related problems, and the score of the T-EAT-10 was found to be independently associated with both neuropathy and reflux complaint. FEES results pointed out that swallowing efficiency was relatively reduced in the target population. However, further research is still necessary before obtaining a definitive answer to oropharyngeal swallowing problems in patients with T2DM.

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.

Gastrointestinal symptoms in pediatric patients with type 1 diabetes mellitus

Background Various gastrointestinal (GI) symptoms are associated with diabetes. Common GI complaints associated with the manifestation of the disease include abdominal pain, diarrhea, nausea, bloating and vomiting. There have been very few studies examining GI problems of pediatric patients with type 1 diabetes mellitus (T1DM). The aims of this study were to find out the prevalence of GI symptoms in pediatric patients with T1DM and to determine the correlation among such symptoms, duration of diabetes and glycemic control. Methods One hundred and thirty-seven (median age 13.2 years, female 45.3%) patients with T1DM were examined. Demographic features, GI symptoms, signs and physical examination findings of the patients were recorded by pediatric gastroenterology specialists for the differential diagnosis and exclusion of other etiologies. Complete blood count, blood glucose, lipid profile, electrolytes, amylase, lipase, celiac antibodies and glycated hemoglobin (HbA1c) levels were evaluated and stool examination was performed. Endoscopy was performed on the patients who had refractory GI complaints. Gastric emptying (GE) time was evaluated using GE scintigraphy. Results Overall, 74 (54%) patients had ≥1 GI complaints. Patients often reported gastroesophageal reflux (32.8%) and abdominal pain (18%). The most significant findings in terms of GI symptoms were determined when patients were classified according to the glycemic control status. Reflux and dyspeptic symptoms were significantly more common in poorly or very poorly controlled diabetic patients (p=0.003 and p=0.004, respectively). Conclusions Diabetes can affect the entire GI tract, and GI symptoms are common in pediatric patients. We recommend that T1DM patients be evaluated for GI symptoms.

Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis

OBJECTIVES

Gastro-oesophageal reflux symptoms are common in the community, but there has been no definitive systematic review and meta-analysis of data from all studies to estimate their global prevalence, or potential risk factors for them.

DESIGN

Medline, Embase and Embase Classic were searched (until September 2016) to identify population-based studies that reported the prevalence of gastro-oesophageal reflux symptoms in adults (≥15 years); gastro-oesophageal reflux was defined using symptom-based criteria or questionnaires. The prevalence was extracted for all studies, and according to the criteria used to define it. Pooled prevalence, according to study location and certain other characteristics, OR and 95% CIs were calculated.

RESULTS

Of the 14 132 citations evaluated, 102 reported the prevalence of gastro-oesophageal reflux symptoms in 108 separate study populations, containing 460 984 subjects. Prevalence varied according to country (from 2.5% in China to 51.2% in Greece) and criteria used to define gastro-oesophageal reflux symptoms. When only studies using a weekly frequency of heart burn or regurgitation to define presence were considered, pooled prevalence was 13.3% (95% CI 12.0% to 14.6%). Prevalence was higher in subjects ≥50 years (OR 1.32; 95% CI 1.12 to 1.54), smokers (OR 1.26; 95% CI 1.04 to 1.52), non-steroidal anti-inflammatory drug (NSAID)/aspirin users (OR 1.44; 95% CI 1.10 to 1.88) and obese individuals (OR 1.73; 95% CI 1.46 to 2.06).

CONCLUSIONS

The prevalence of gastro-oesophageal reflux symptoms varied strikingly among countries, even when similar definitions were used to define their presence. Prevalence was significantly higher in subjects ≥50 years, smokers, NSAID users and obese individuals, although these associations were modest.

Risk Factors for Gastroesophageal Reflux Disease in Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal tract diseases worldwide. GERD has an effect on the patients' quality of life as well as the health care system that can be prevented by identifying its risk factors among the population. Hence, we applied this study to assess the GERD's risk factors in Saudi Arabia.

Methods

A cross-sectional study was designed to assess the GERD's risk factors among the community of Saudi Arabia. The sample was collected randomly during the period from November to December 2016. Through a self-administered validated GERD questionnaire (GerdQ), GERD was diagnosed. Then, the GERD's risk factors were assessed among all participants. The data were analyzed using Statistical Package for Social Sciences version 21.0; the Student's t-test was used to assess the association of GERD and risk factors.

Results

A total of 2,043 subjects participated in the study. The characteristics and behaviors of participants statistically significant with GERD were positive family history (39.3%), obese (body mass index > 30 kg/m²) (39.4%), not performing weekly regular physical activities ≥ 30 min (31.1%) and smoking (39.3%). GERD was commonly noticed in participants on analgesics (38.4%), not taking fibers (37.4%), drinking tea (33.4%), eating greasy (31.2%) and fast food (32.7%), and these were statistically significant with GERD (P ≤ 0.05).

Conclusion

The characteristics and behaviors associated with GERD in Saudi population are family history of GERD, obesity, sedentary lifestyle and smoking. Other common risk factors correlated with GERD are analgesics intake, no fibers intake, drinking tea, greasy and fast food intake.

Eating Behaviours and Prevalence of Gastroesophageal Reflux Disease in Japanese Adult Patients With Type 2 Diabetes Mellitus: The Dogo Study

OBJECTIVES

In the general population, late-night dinner is positively associated with gastroesophageal reflux disease (GERD). No evidence exists regarding the relationship between eating behaviours and GERD in patients with type 2 diabetes mellitus, though the prevalence of GERD in patients with type 2 diabetes is higher than in those without diabetes. We conducted this study to investigate the association between eating behaviours and GERD in Japanese patients with type 2 diabetes.

METHODS

The study's subjects were 817 Japanese patients with type 2 diabetes. GERD was defined as being present when a subject had a Quality of Life and Utility Evaluation Survey Technology (QUEST) score of 4 or higher. The assessment of eating behaviour was performed by self-administered questionnaire. Subjects were considered positive for late-night dinner if they answered yes to the question "Do you eat dinner within 2 hours before bedtime at least 3 times per week?

RESULTS

The prevalence values of GERD, skipping breakfast, bedtime snacking, late-night dinner and fast eating were 32.0%, 13.7%, 27.1%, 28.8%, and 44.4%, respectively. Late-night dinner was independently positively associated with GERD in patients with type 2 diabetes; the adjusted odds ratio was 1.46 (95% CI 1.03 to 2.05). No relationships were found between skipping breakfast, bedtime snacking or fast eating and GERD.

CONCLUSIONS

Late-night dinner may be positively associated with GERD in Japanese patients with type 2 diabetes.

Does gastroesophageal reflux increase chronic obstructive pulmonary disease exacerbations?

BACKGROUND

The relationship between chronic obstructive pulmonary disease (COPD) exacerbations and gastroesophageal reflux (GER) has been investigated less than asthma-GER. We aimed to evaluate the presence of GER in patients with COPD and its impact on exacerbations.

METHODS

We included 24 patients with stable mild-moderate stage COPD and 19 volunteers as the control group. We conducted a gastroesophageal reflux disease (GERD) symptom questionnaire, gastroscopy, manometry, and an ambulatory 24-h pH-impedance study.

RESULTS

According to the GERD questionnaire, only 5 (20.8%) patients with COPD had typical GER symptoms. According to the 24-h pH-impedance study, the mean DeMeester score (DMS) was 38.1 ± 34.6 in the COPD group and 13.3 ± 16.8 in the control group (p = 0.01). The acid reflux (DMS > 14.7) rate was higher in patients with COPD than in controls (73.9% vs 26.3%, p = 0.01). The symptom association probability positivity rate was 17.4% (n = 4) in the COPD group, which was similar to the controls (p = 0.11). The mean proximal extension rate of reflux (Z 17 cm) was 26.4 ± 12.9% in the COPD group. The proximal extent of reflux was positively correlated with the number of COPD exacerbations per year (p = 0.03, r = 0.448). In the motility results, only 2 (20%) patients in the control group had a minor motility disorder. Seventeen (70.8%) patients in the COPD group had a minor motility disorder, and 4 (16.7%) had major motility disorders (p < 0.001).

CONCLUSION

In our study, gastroesophageal reflux was frequent in patients with COPD, but only a quarter had typical reflux symptoms. The proximal extent of reflux may trigger frequent exacerbations of COPD.