上海宝山地区胃食管反流病流行学研究及生活质量评价

[目的]探讨上海宝山地区人群胃食管反流病(GERD)的患病率及发病危险因素。[方法]采用中文版反流性疾病问卷(RDQ),应用随机、整群、分层抽样方法对上海宝山地区≥18岁居民进行调查,调查方式为面试。[结果]实际调查3 126例(男1 635例,女1 491例),年龄18~87(43.5±17.1)岁;按RDQ评分≥12分定义,GERD的患病率为8.5%(266/3 126);30~40岁人群GERD患病率与其他年龄比较,差异有统计学意义(P0.05);男性患病率高于女性,但两性比较差异无统计学意义(P0.05)。GERD组伴发口咽疾病、鼾症、哮喘的比例明显高于非GERD组,2组比较差异有统计学意义(P0.05);饱食、便秘、吸烟是GERD患病的独立危险因素。GERD组SF-36量表8个维度生活质量评分和量表总评分均明显低于非GERD组,差异有统计学意义(P0.05)。[结论]上海宝山地区GERD患病率略高于上海市水平,GERD患者生活质量较正常健康人群明显下降。     

胃食管反流病相关危险因素研究

[目的]研究胃食管反流病(GERD)的相关危险因素。[方法]对420例消化科门诊患者行反流性疾病问卷表(RDQ)调查,以RDQ评分≥12分为GERD的诊断标准,其中60例列入GERD组,其余360例列入非GERD组,同时对2组对象的饮食和生活习惯进行问卷调查。[结果]GERD组中常吸烟、饮酒、喝咖啡、睡前进食的比例均明显高于非GERD组(P0.05),但常饮浓茶的比例在2组患者中差异无统计学意义(P0.05)。[结论]不良的饮食和生活习惯是诱发GERD的重要危险因素,重视改变不良生活方式可能减轻GERD的发生和发展。     

浙江省内科门诊人群胃食管反流病及危险因素流行病学调查

目的了解浙江省内科门诊人群胃食管反流病的患病率，分析与之相关的危险因素。方法流行病学调查采用整体随机抽样、反流性疾病问卷（reflex diagnostic questionnaire，RDQ）调查方式，并采用多种统计学方法进行统计分析。．结果浙江省内科门诊人群胃食管反流病的初筛患病率为7．28％，95％可信区间为6．87％～7．69％。不同性别、年龄、体力劳动强度、婚姻状况间胃食管反流病患病率差异有统计学意义（P〈0．05）。进食过饱、常饮酸性饮料、常食辛辣食物、油腻食物、常饮浓茶、常进甜食、吸烟、饮酒、便秘者胃食管反流病患病率明显升高，差异有统计学意义（P〈0．01）。单因素Logistic回归分析发现：性别、年龄、体力劳动强度、是否上夜班、婚姻状况是胃食管反流病的危险因素；多因素Logistic回归分析发现：年龄、是否上夜班、体力劳动强度、婚姻状况、进食过饱、常食油腻食物、常饮浓茶、常进甜食、便秘等可能是危险因素。结论问卷调查表是临床诊断胃食管反流病的一种简单、有效的方法。胃食管反流病有众多危险因素，临床上需引起高度重视。     

畲族人群胃食管反流病流行病学研究

背景:胃食管反流病(GERD)是一种常见疾病,其发病率可能与地理环境和种族有关。目前少数民族GERD流行病学的调查少见。目的:了解宁德市畲族人群中GERD患病率及其危险因素。方法:采用整群随机抽样法抽取宁德市3个畲族自然村,以胃食管反流病问卷(Gerd Q)评分≥8分诊断为GERD,采用问卷的形式调查GERD的患病率和危险因素。结果:共936名畲族人完成调查,其中GERD患者89例,患病率9.50%。单因素分析显示,体质指数(BMI)≥24 kg/m2、饮浓茶、油腻饮食人群的GERD患病风险明显升高(P均0.01)。多因素分析发现,BMI≥24 kg/m~2(OR=3.022,95%CI:1.917~4.765)、饮浓茶(OR=2.145,95%CI:1.338~3.438)、油腻饮食(OR=2.016,95%CI:1.208~3.318)为畲族GERD发病的危险因素。结论:福建省畲族人群GERD患病率较高,其发生与超重、饮食习惯密切相关。     

贵州省安顺地区人群胃食管反流病流行病学调查

目的:探讨贵州省安顺地区人群胃食管反流病(gastroesophageal reflux disease, GERD)的患病.方法:2006-07/2006-12采用中文版反流性疾病问卷(RDQ), 应用随机、整群、分层抽样方法对安顺地区人群进行调查. 调查方式为面试, 所得资料均输入电脑, 建立数据库, 用SPSS14.0软件行卡方检验及t检验等.结果:被调查者共1692例(男836例, 女856例),应答率96.2%; 年龄10-87(平均年龄42.2±15.3)岁. 按RDQ评分(≥12)定义, 安顺地区人群GERD的患病率为6.9%. 男性患病率高于女性, 但差异无统计学意义( P>0.05); 年龄分布,GERD的患病率随年龄增长而增高( P<0.05).结论:贵州省安顺地区人群中GERD患病率明显高于广东省社区人群GERD患病率, 也高于北京, 上海两地GERD患病率.     

福建省人群胃食管反流病流行病学调查

Objective To assess the prevalence of gastroesophageal reflux disease(GERD) in the population of Fujian province, and to analyze the risk factors in relation to the disease. Methods A survey on GERD symptoms and its related factors was carried out in the population of Fuzhou city in Fujian province using a stratified random sampling method. According to reflux disease questionnaire (RDQ) score, the subjects were divided to GERD group with Sc≥ 12 and control group with Sc＜ 12.The risk factors related to GERD were compared between two groups. Results A total of 1347residents were investigated. The prevalence of GERD was 8.76 %, and male to female ratio wasincreased in population above 40 years of age (P＜0.05). The incidence of GERD in subjects with different occupations was as follows: the businessmen [17.91%(12/67)], retirees [13.48%(12/89)]and soldiers [2.94%(2/68)]. Symptoms including abdominal distension, belching, nausea, vomiting,dyspepsia were common in GERD group compared to control group (P ＜ 0.01). Besides, the laryngitis, pharyngitis and mouth ulcer were common in GERD group compared to control group ( P＜0.05). The risk factors of GERD were eating greasy (OR= 1.589) and sweetmeat (OR= 2.413),overeating (OR = 2.053), constipation (OR = 1.650), acridity food (OR = 1.366 ), coffee (OR =1.295), strong tea (OR= 1.362). Conclusions The prevalence of GERD is high in the population of Fujian province, and many factors are closely related to reflux.     

福建省人群胃食管反流病流行病学调查

Objective To assess the prevalence of gastroesophageal reflux disease(GERD) in the population of Fujian province, and to analyze the risk factors in relation to the disease. Methods A survey on GERD symptoms and its related factors was carried out in the population of Fuzhou city in Fujian province using a stratified random sampling method. According to reflux disease questionnaire (RDQ) score, the subjects were divided to GERD group with Sc≥ 12 and control group with Sc＜ 12.The risk factors related to GERD were compared between two groups. Results A total of 1347residents were investigated. The prevalence of GERD was 8.76 %, and male to female ratio wasincreased in population above 40 years of age (P＜0.05). The incidence of GERD in subjects with different occupations was as follows: the businessmen [17.91%(12/67)], retirees [13.48%(12/89)]and soldiers [2.94%(2/68)]. Symptoms including abdominal distension, belching, nausea, vomiting,dyspepsia were common in GERD group compared to control group (P ＜ 0.01). Besides, the laryngitis, pharyngitis and mouth ulcer were common in GERD group compared to control group ( P＜0.05). The risk factors of GERD were eating greasy (OR= 1.589) and sweetmeat (OR= 2.413),overeating (OR = 2.053), constipation (OR = 1.650), acridity food (OR = 1.366 ), coffee (OR =1.295), strong tea (OR= 1.362). Conclusions The prevalence of GERD is high in the population of Fujian province, and many factors are closely related to reflux.     

糖尿病与胃食管反流病临床流行病学研究

目的通过对2型糖尿病患者进行胃食管反流病(GERD)的流行病学调查,探讨其与胃食管反流病发病率的相关性。方法对500例2型糖尿病患者进行反流性疾病问卷调查,其中相关临床指标包括性别、年龄、吸烟、饮酒、BMI、糖尿病病程、空腹血糖、糖尿病并发症等,探讨其与胃食管反流病的相关性。结果糖尿病组GERD发生率(14.2%)较非糖尿病组(7.0%)明显增高(P0.05);糖尿病组中年龄65岁组GERD患病率最高(16.9%),而45岁以下年龄组患病率最低(7.4%);女性人群在糖尿病组中的GERD阳性率(14.8%)明显高于非糖尿病组(5.6%,P0.05);糖尿病病程、糖尿病并发症与糖尿病并发GERD相关(P0.05),吸烟、饮酒、BMI、空腹血糖与GERD无明显相关性(P0.05)。结论糖尿病并发GERD的患病率较高;糖尿病患者中年龄65岁组GERD发病率高于其他年龄组;女性人群在高血糖时发生GERD相关症状的危险性增大;糖尿病病程、糖尿病并发症与糖尿病合并GERD相关。     

胃食管反流病患者夜间反流与睡眠障碍情况调查

目的 研究胃食管反流病(GERD)患者夜间反流症状、睡眠障碍的发生率及相互关系.方法 全国51个城市的125家医院对7520例门诊GERD患者进行问卷调查.获得有效问卷7515份,男、女比例为1.36∶1.调查项目包括:GERD症状、夜间反流症状发生率、睡眠障碍的表现及夜间反流与睡眠障碍的关系.结果 GERD主要症状为烧心(88.3%)、反流(72.2%)、胸痛(37.6%)、上腹痛(35.5%)、咽部不适(30.4%)、咳嗽(12.1%)及哮喘(3.0%).7515例患者中,有夜间症状者4216例(56.1%),经内镜证实的糜烂性食管炎(EE)及非糜烂性胃食管反流病(NERD)患者夜间反流症状发生率分别为56.1%及53.1%,两者间差异无统计学意义(P＞0.05).有夜间反流症状者80.1%存在睡眠障碍,明显高于无夜间反流症状者的25.8%(P＜0.01).在睡眠障碍中,以睡眠质量下降和日间残留效应为多(分别为78.2%和70.1%),有夜间反流症状者,睡眠障碍病程发生在反流症状之后的占58.7%,明显高于发生在反流症状之前的21.5%(P＜0.01).有夜间反流的EE及NERD患者的睡眠障碍发生率分别为80.0%及77.1%,两者间差异无统计学意义(P＞0.05).在治疗GERD伴睡眠障碍方案中以质子泵抑制剂治疗为主(53.8%),其次为安眠药(24.5%),联合用药(9.5%).结论 GERD患者常有夜间反流症状及睡眠障碍,夜间反流可能是患者睡眠障碍的原因,治疗中应合并使用质子泵抑制剂.     

老年胃食管反流病患者临床特征分析

目的 探讨老年胃食管反流病(GERD)患者的临床特征,为临床诊断、治疗提供帮助.方法 根据GERD蒙特利尔的标准、中国胃食管反流病共识意见等,将GERD患者分为老年组(年龄≥65岁)与中青年组(年龄＜65岁);通过问卷调查,分析2组GERD患者的食管裂孔疝(HH)、食管炎(洛杉矶标准)、临床症状(反流、烧心等)、生活质量.结果 两组性别比差异无统计学意义(P＞0.05).与中青年GERD患者比较:老年患者重度食管炎(LC级+LD级)比例高(P＜0.05);典型反酸、烧心症状轻(P＜0.05),食管外症状发生率高(P＜0.05);但HH发生率差异无统计学意义(P＞0.05).老年患者生理功能、总体健康、活力、社会功能、精神健康、躯体生理健康总评和精神心理健康总评积分与年轻组差异无统计学意义(P＞0.05),仅生理职能、躯体疼痛、情感职能积分较中青年组高(P＜0.05).结论 老年GERD患者典型反流症状(反食、烧心)较少见,易发生重度食管炎,但老年GERD患者生活质量无明显下降.     

Epidemiological study of symptomatic gastroesophageal reflux disease in China: Beijing and Shanghai

OBJECTIVE : To explore the 1‐year point prevalences (July–September 1996) of symptomatic gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD) and reflux esophagitis (RE) in the adult population of two Chinese city‐regions (Beijing and Shanghai) and to identify the conditions that predispose patients to GERD. METHODS : Phase I: 5000 residents of the two regions aged between 18 and 70 years were studied via a questionnaire. The study was carried out by cluster sampling from city, suburban and rural areas by using simple random sampling. Symptom scores (Sc) of the intensity and frequency of heartburn, acid reflux and regurgitation within 1 year of the time of study were taken as indices of acid reflux (highest score, Sc = 18) and Sc ≥ 6 indicated the presence of symptomatic GER. Phase II: a small number of patients who were identified as having symptomatic GER in the survey were enrolled in a case– control study using gastroscopy and 24‐h pH monitoring to obtain correct diagnostic rates of GERD and RE. Estimates of the prevalence of GERD and RE were then adjusted according to the rates of correct diagnosis. RESULTS : A total of 4992 subjects completed the survey, 2.5% had heartburn once daily, 8.97% had symptomatic GER (Sc ≥ 6) and the male to female ratio was 1:1.11. Point prevalences for the year for GERD and RE were 5.77 and 1.92%, respectively. Stratified analysis indicated that the prevalence of symptomatic GER in Beijing (10.19%) was higher than that in Shanghai (7.76%) and there was also a higher prevalence of GER in males, manual laborers, people from rural areas and people older than 40 years of age in Beijing as compared with Shanghai. Stepwise logistic analysis indicated that GER had a close relationship with dental, pharyngolaryngeal disorders and respiratory diseases. The conditions that predispose patients to GERD are (OR, odds ratio): age > 40 (OR = 1.01), eating greasy/oily food (OR = 6.56), overeating (OR = 1.99), tiredness (OR = 2.35), emotional stress (OR = 2.22), pregnancy (OR = 6.80) and constipation (OR = 1.65). CONCLUSIONS : Gastroesophageal reflux disease is a common disease in the adult Chinese population and it is more common in Beijing than in Shanghai.     

High Prevalence of Gastroesophageal Reflux Symptoms in Patients with Non-Alcoholic Fatty Liver Disease Associated with Serum Levels of Triglyceride and Cholesterol but Not Simple Visceral Obesity

Background/Aims: Visceral obesity is commonly involved in the pathogenesis of gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease (NAFLD). However, other characteristic factors different from visceral obesity are associated with the pathogenesis of NAFLD. We investigated the prevalence of GERD symptoms in patients with NAFLD and its associated risk factors. Methods: NAFLD (n = 96) and controls (n = 139) were enrolled in this study. GERD symptoms were evaluated by using a frequency scale for the symptoms of GERD. Results: GERD symptom score and its prevalence rate were higher in the NAFLD group (7.4 ± 0.7, 37%) than those seen in the control groups (4.5 ± 0.4, 20%), which was independent of sex, age, and body mass index (BMI). GERD symptoms were correlated with insulin resistance (r = 0.167, p = 0.011), total cholesterol (T-CHO) (r = 0.138, p = 0.034), triglyceride (TG) (r = 0.178, p = 0.006), or immunoreactive insulin (r = 0.173, p = 0.008) but not BMI (r = 0.089, p = 0.175). GERD symptoms of the NAFLD group were significantly severer in the higher group of T-CHO and TG levels than those in the lower group. Multivariate analysis proved that risk factors related to GERD symptoms were TG (OR 3.96, 95% CI 1.31-11.9) and T-CHO (OR 3.39, 95% CI 1.11-10.3). Conclusion: The severity and prevalence of GERD symptoms in patients with NAFLD were high, which was associated with serum levels of TG and T-CHO but not BMI.     

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/m² were independent risk factors associated with GERD symptoms. Age, alcohol, coffee, tea, and tobacco smoking do not seem to be risk factors for reflux.     

Epidemiology of gastroesophageal reflux disease： A general population-based study in Xi＇an of Northwest China

AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi‘an, a northwestern city of China, and to explore the potential risk factors of GERD. METHODS: Symptoms suggestive of GERD, functional dyspepsia (FD), irritable bowel syndrome (IBS), upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified random samples of 2 789 residents aged 18-70 years in Xi‘an by using a standardized questionnaire. METHODS: With a response rate of 91.8%, the prevalence of SGER was 16.98% (95% CI, 14.2-18.92) in Xi‘an adults, and no gender-related difference was observed (P&lt;0.05). SGER was more common among subjects aged 30-70 years than in those aged 18-29 years (P&lt;0.01). The prevalence of SGER in rural, urban and suburban subjects was 21.07%, 17.44% and 12.12%, respectively, and there was a significant difference between rural, urban and suburban regions (P&lt;0.05). Compared with subjects without SGER, the prevalence of symptoms suggestive of FD and IBS, pneumonia, asthma, bronchitis, laryngitis, pharyngitis, chronic cough, wheeze, globus sensation, oral ulcer and snore was significantly increased in subjects with SGER (P&lt;0.01). Heavy smoking (OR=5.76; CI, 3.70-6.67), heavy alcohol use (OR=2.85; CI, 1.67-4.49), peplJc ulcer (OR=5.76; CI, 3.99-8.32), cerebral palsy (OR=3.97; CI, 1.97-8.00), abdominal operation (OR=2.69; CI, 1.75-4.13), obesity(OR=2.16; CI, 1.47-3.16), excessive food intake (OR= 1.43;CI, 1.17-1.15), sweet food (OR=1.23; CI, 0.89-1.54), and consumption of coffee (OR= 1.23; CI, 0.17-2.00) were independently associated with SGER. The episodes of GERD were commonly precipitated by dietary factors (66.05%), followed by body posture (26.54%), ill temper (23.72%), fatigue (22.32%) and stress (10.93%). CONCLUSION: GERD is common in Xi‘an‘s adult population with a mild or moderate degree. The etiology and pathogenesis of GERD are probably associated with FD, IBS, and some respiratory, laryngopharyngeal and odontostological diseases or symptoms. Some lifestyles, diseases and dietary factors are the risk factors of GERD.     

Prevalence of gastroesophageal reflux and risk factors for erosive esophagitis in obese patients considered for bariatric surgery

BackgroundGastroesophageal reflux disease (GERD) is common in obese individuals. Prospective studies investigating validated GERD questionnaires and clinical parameters at identifying erosive esophagitis (EE) in this population are limited.ObjectiveTo prospectively evaluate the prevalence of GERD in obese patients considered for bariatric surgery and identify risk and predictive factors for EE.MethodsEligible patients completed two validated questionnaires: GERDQ and Nocturnal Symptom Severity Impact (N-GSSIQ) before routine esophagogastroduodenoscopy.Results242 consecutive patients were enrolled (130 females; mean age 37.8 ± 11.8 years; mean BMI 40.4 ± 5.3 kg/m²). The overall prevalence of gastroesophageal reflux (GERDQ ≥ 8, EE and/or PPI use) was 62.4%. EE was identified in 82 patients (33.9%) including 13/62 (21.0%) receiving PPIs at baseline. Multivariate logistic regression identified GERDQ ≥ 8 (OR = 6.3, 95%CI 3.0–13.1), hiatal hernia (OR = 4.2, 95%CI 1.6–10.7), abnormal Hill grade (OR = 2.7, 95%CI 1.4–5.4), and tobacco use (OR = 2.5, 95%CI 1.2–4.9) as independent risk factors for EE. A pre-endoscopic composite assessment including GERDQ ≥ 8 and presence of severe nocturnal reflux symptoms had 90% specificity and 20.7% sensitivity in identifying EE (NPV 68.9% and PPV 51.5%).ConclusionGERD is highly prevalent in obese patients. Anthropometric data and GERD questionnaires have limited accuracy at predicting erosive disease. Pre-operative endoscopic assessment in this population appears warranted.     

Hygiene could affect GERD prevalence independently: a population-based study in Tehran

OBJECTIVE: Population-based data on gastroesophageal reflux disease (GERD) in Iran are limited. Current study is going to determine the prevalence of GERD in Tehran, Iran, and its association with potential risk factors. METHODS: In this cross-sectional study, a random clustered sample of Tehran province permanent households was selected from the latest postcodes. Data were collected by direct interview for each person aged 18-65 yr. GERD was defined as the existence of at least weekly episodes of heartburn and/or acid regurgitation during the last 6 months. All participants were asked about past and recent sanitary conditions, oral hygiene, and smoking. Odds ratios and 95% confidence intervals (CI) were calculated using multivariable analysis. RESULTS: Interview was performed with 2,561 eligible subjects (42.3% men). Response rate was 84.8%. The prevalence of GERD was 21.2% (95% CI 18.7-23.7). According to multivariable logistic regression analyses, individuals whose drinking water was obtained from well or tank during childhood were more prone to experience GERD symptoms (OR 1.54, 95% CI 1.03-1.77 and OR 2.46, 95% CI 1.53-3.96, respectively). We also detected significant associations with increasing number of missing teeth (P value for linear trend = 0.02) and history of unpurified water consumption during past 10 yr (P < 0.001). Current smokers had a higher prevalence of reflux (OR 1.82, 95% CI 1.32-2.51). CONCLUSION: The prevalence of GERD in our Iranian population was considerably higher than that reported from other Asian studies approaching western figures. GERD prevalence was significantly associated with the history of unpurified water consumption, poor sanitary conditions of childhood, number of missing teeth, and smoking in this population.     

No association between gallstones and gastroesophageal reflux disease

OBJECTIVES: Gallstones and hiatal hernia reportedly have been linked to similar dietary factors prevalent in western countries, and patients with cholelithiasis or previous cholecystectomy have been reported to have more duodenogastric reflux than healthy controls. Nonetheless, the contribution of duodenogastric reflux to the development of gastroesophageal reflux disease (GERD) remains controversial. The present study was aimed to assess the association between gallstone disease and GERD. METHODS: Outpatients from general medical clinics who underwent upper GI endoscopy and abdominal ultrasonography were recruited into a case-control study. A case population of 790 patients with various grades of GERD was compared to a control population of 407 patients without GERD. In a multivariate logistic regression, the presence of GERD served as the outcome variable, whereas the presence of gallstones, hiatal hernia, social habits, and demographic characteristics served as predictor variables. RESULTS: No associations were found between the presence of cholelithiasis or previous cholecystectomy and GERD or between the presence of cholelithiasis or previous cholecystectomy and hiatal hernia. The severity of GERD also remained unaffected by the presence of gallstones. The occurrence of GERD was influenced only by hiatal hernia (odds ratio [OR] = 3.15, 95% CI = 2.44-4.08), alcohol consumption (OR = 1.47, CI = 1.08-1.99), and not by cholelithiasis (OR = 1.02, CI = 0.68-1.51), or cholecystectomy (OR = 0.90, CI = 0.64-1.28). The frequency of GERD among hiatus hernia patients with gallstones (437/592 = 74%) was similar to the frequency of GERD among hiatus hernia patients without gallstones (168/220 = 76%, p = 0.516). CONCLUSIONS: Neither cholelithiasis nor cholecystectomy poses a risk for the occurrence of GERD or hiatal hernia. Gallstone disease does not seem to influence the integrity of the esophageal mucosa through GERD.     

反流性疾病问卷表在军人胃食管反流病中的诊断价值

[目的]探讨反流性疾病问卷表(RDQ)在军人胃食管反流病(GERD)中的诊断价值。[方法]采用多阶段、分层、整群随机抽样的方法对驻闽某部军人进行反流性疾病问卷调查,记录被调查者过去4周内烧心、非心源性胸痛、反酸和反流4种症状出现的频率和程度积分,以RDQ评分≥12分作为GERD的诊断标准,计算军人中GERD的患病率,同时分析经电子胃镜检查证实为反流性食管炎(RE)患者的RDQ评分情况。[结果]研究得出军人GERD的患病率为6.77%,经胃镜检查420例中明确诊断为RE 60例(RE组)和内镜检查正常360例(非RE组)的RDQ评分差异有统计学意义(P0.01),说明评分与发生RE之间有较大关联。[结论]RDQ评分量表可以作为初步诊断军人GERD的一个良好的筛选试验。     

Diabetes mellitus is an independent risk for gastroesophageal reflux disease among urban African Americans

An association between gastroesophageal reflux disease (GERD) and diabetes mellitus (DM) has been reported. Studies have not been population‐based and have failed to include a representative sample of African American subjects. The aim of the study was to determine if DM is independently associated with GERD among urban African Americans. Single‐center, population‐based survey utilizing a complex, stratified sampling design. To obtain a simple random sample of the entire African American community, targeted survey zones and hand‐delivered invitations were identified. Participating subjects had to be self‐described African American, age ≥18. Surveys were completed at a computer terminal assisted by a research coordinator. Four hundred nineteen subjects (weighted sample size of 21 264 [20 888–23 930]). GERD prevalence was 23.7% (95% confidence interval [CI] 23.2–23.9). GERD prevalence was 41.5 % in those with DM versus 20.6 % for those without (P < 0.001). Those with GERD had DM longer but had lower glycohemoglobin levels. The prevalence of ≥2 DM comorbidities was higher in those with GERD (odds ratio [OR] = 2.06; 95% CI 1.71–2.48). In the final model, age >40, DM, increasing body mass index, harmful drinking, and increasing smoking dependence were independently associated with GERD. For DM, there was significant effect modification by gender. In males, the risk was (OR = 4.63; 95% CI 3.96–5.40), while in females, the risk was markedly attenuated (OR = 1.79; 95% CI 1.61–2.00). Among urban African Americans, there is an independent association between DM and GERD that appears to be stronger in men. More information is needed to understand this association.     

Diet, Lifestyle and Gender in Gastro-Esophageal Reflux Disease

BACKGROUND: Studies indicate that gastro-esophageal reflux disease (GERD) is associated with obesity, smoking, esophagitis, diet, and lifestyle. AIM: To identify risk factors associated with GERD among patients presenting to a tertiary GI clinic in Italy. METHODS: Patients with a first diagnosis of GERD based on heartburn and/or regurgitation and/or esophagitis at the endoscopic examination were enrolled. A control group with neither GERD symptoms nor esophagitis was enrolled from the same hospital. Each subject completed a questionnaire including demographic information, lifestyle (e.g., exercise, alcohol, coffee, chocolate, and soda consumption, smoking, having large meals), and frequency of bowel movement. For each participant the body mass index (BMI) was calculated. RESULTS: Five hundred subjects were enrolled including 300 GERD patients and 200 controls. Females had significantly higher prevalence of GERD than males (66 vs. 48%, P = 0.001, OR = 2.1, 95% CI = 1.5-3.1). There was an inverse relationship between the level of education and presence of GERD (76% of GERD patients has completed only elementary school (OR = 2.1, 95% CI = 1.7-4.9). Obesity (BMI of > or =95th percentile for their age/gender specific) was significantly related to GERD (OR = 1.8, P = 0.01). None of the other variables studied showed significant associations with GERD. Logistic regression analysis showed that BMI > or =95th percentile, gender, and low education level were significant risk factors for GERD. CONCLUSIONS: Understanding the epidemiology and risk factors for GERD in a region is the first step in designing prevention and treatment strategies.