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Erschienen in: Digestive Diseases and Sciences 4/2017

23.01.2017 | Original Article

Overlap of Dyspepsia in Patients with Gastroesophageal Reflux Disease: Impact of Clinical, Metabolic, and Psychosocial Characteristics

verfasst von: Ching-Sheng Hsu, Shu-Hui Wen, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Wei-Yi Lei, Fabio Pace, Chien-Lin Chen

Erschienen in: Digestive Diseases and Sciences | Ausgabe 4/2017

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Abstract

Background

Gastroesophageal reflux disease (GERD) and dyspepsia are highly prevalent in the general population with significant symptom overlap, while the interaction between both remains poorly understood.

Aim

To examine whether GERD overlapping dyspepsia would have an impact on clinical and psychological features as compared with GERD alone.

Methods

We performed a cross-sectional study in a GERD cohort (n = 868) that was previously recruited from a population-based GERD survey (n = 2752). We compared the clinical and psychological factors between patients with and without dyspeptic symptoms “epigastric pain or burning.” All participants were evaluated with Reflux Disease Questionnaire score, Pittsburgh Sleep Quality Index score, Taiwanese Depression Questionnaire score, and State-Trait Anxiety Inventory score. Endoscopic findings were classified according to the Los Angeles classification.

Results

Among the GERD population, 107 subjects had overlapping “epigastric pain or burning” (GERD-D), and 761 did not have these symptoms (GERD alone). GERD-D subjects had more severe GERD symptoms and were more often associated with irritable bowel syndrome (IBS) (OR 3.54, 95% CI 1.92–6.52) as compared subjects with GERD alone. In addition, GERD-D subjects had lower quality of sleep (OR 1.11, 95% CI 1.01–1.21), higher depression (OR 1.06, 95% CI 1.02–1.10), lower blood pressure (OR 0.45, 95% CI 0.22–0.95), and higher serum total cholesterol levels (OR 2.78, 95% CI 1.36–5.67) than GERD alone.

Conclusions

GERD-D subjects are characterized with worsening clinical symptoms as well as higher psychosocial, IBS, and metabolic comorbidities, but less erosive esophagitis. Our results indicate that clinical awareness of such overlapping condition would help optimize the management of GERD in clinical practice.
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Literatur
1.
Zurück zum Zitat Tack J, Becher A, Mulligan C, et al. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther. 2012;35:1257–1266.CrossRefPubMed Tack J, Becher A, Mulligan C, et al. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther. 2012;35:1257–1266.CrossRefPubMed
2.
Zurück zum Zitat Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–1511.CrossRefPubMed Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122:1500–1511.CrossRefPubMed
3.
Zurück zum Zitat Lee YC, Yen AM, Tai JJ, et al. The effect of metabolic risk factors on the natural course of gastro-oesophageal reflux disease. Gut. 2009;58:174–181.CrossRefPubMed Lee YC, Yen AM, Tai JJ, et al. The effect of metabolic risk factors on the natural course of gastro-oesophageal reflux disease. Gut. 2009;58:174–181.CrossRefPubMed
4.
Zurück zum Zitat Goh KL. Gastroesophageal reflux disease in Asia: a historical perspective and present challenges. J Gastroenterol Hepatol. 2011;26:2–10.CrossRef Goh KL. Gastroesophageal reflux disease in Asia: a historical perspective and present challenges. J Gastroenterol Hepatol. 2011;26:2–10.CrossRef
5.
Zurück zum Zitat Lee YC, Wang HP, Chiu HM, et al. Comparative analysis between psychological and endoscopic profiles in patients with gastroesophageal reflux disease: a prospective study based on screening endoscopy. J Gastroenterol Hepatol. 2006;21:798–804.CrossRefPubMed Lee YC, Wang HP, Chiu HM, et al. Comparative analysis between psychological and endoscopic profiles in patients with gastroesophageal reflux disease: a prospective study based on screening endoscopy. J Gastroenterol Hepatol. 2006;21:798–804.CrossRefPubMed
6.
Zurück zum Zitat Lei WY, Yu HC, Wen SH, et al. Predictive factors of silent reflux in subjects with erosive esophagitis. Dig Liver Dis. 2015;47:24–29.CrossRefPubMed Lei WY, Yu HC, Wen SH, et al. Predictive factors of silent reflux in subjects with erosive esophagitis. Dig Liver Dis. 2015;47:24–29.CrossRefPubMed
7.
Zurück zum Zitat Hsu CS, Liu TT, Wen SH, et al. Clinical, metabolic, and psychological characteristics in patients with gastroesophageal reflux disease overlap with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2015;27:516–522.CrossRefPubMed Hsu CS, Liu TT, Wen SH, et al. Clinical, metabolic, and psychological characteristics in patients with gastroesophageal reflux disease overlap with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2015;27:516–522.CrossRefPubMed
8.
Zurück zum Zitat Ford AC, Forman D, Bailey AG, et al. Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior. Am J Gastroenterol. 2008;103:1229–1239. (quiz 40).CrossRefPubMed Ford AC, Forman D, Bailey AG, et al. Irritable bowel syndrome: a 10-yr natural history of symptoms and factors that influence consultation behavior. Am J Gastroenterol. 2008;103:1229–1239. (quiz 40).CrossRefPubMed
9.
Zurück zum Zitat Kennedy TM, Jones RH, Hungin AP, et al. Irritable bowel syndrome, gastro-oesophageal reflux, and bronchial hyper-responsiveness in the general population. Gut. 1998;43:770–774.CrossRefPubMedPubMedCentral Kennedy TM, Jones RH, Hungin AP, et al. Irritable bowel syndrome, gastro-oesophageal reflux, and bronchial hyper-responsiveness in the general population. Gut. 1998;43:770–774.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012;107:1793–1801. (quiz 802).CrossRefPubMed Lovell RM, Ford AC. Prevalence of gastro-esophageal reflux-type symptoms in individuals with irritable bowel syndrome in the community: a meta-analysis. Am J Gastroenterol. 2012;107:1793–1801. (quiz 802).CrossRefPubMed
11.
12.
Zurück zum Zitat Park H. Functional gastrointestinal disorders and overlap syndrome in Korea. J Gastroenterol Hepatol. 2011;26:12–14.CrossRefPubMed Park H. Functional gastrointestinal disorders and overlap syndrome in Korea. J Gastroenterol Hepatol. 2011;26:12–14.CrossRefPubMed
13.
Zurück zum Zitat Ghoshal UC, Singh R, Chang FY, et al. Epidemiology of uninvestigated and functional dyspepsia in Asia: facts and fiction. J Neurogastroenterol Motil. 2011;17:235–244.CrossRefPubMedPubMedCentral Ghoshal UC, Singh R, Chang FY, et al. Epidemiology of uninvestigated and functional dyspepsia in Asia: facts and fiction. J Neurogastroenterol Motil. 2011;17:235–244.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Manabe N, Haruma K, Hata J, et al. Clinical characteristics of Japanese dyspeptic patients: is the Rome III classification applicable? Scand J Gastroenterol. 2010;45:567–572.CrossRefPubMed Manabe N, Haruma K, Hata J, et al. Clinical characteristics of Japanese dyspeptic patients: is the Rome III classification applicable? Scand J Gastroenterol. 2010;45:567–572.CrossRefPubMed
15.
Zurück zum Zitat Kitapcioglu G, Mandiracioglu A, Caymaz Bor C, et al. Overlap of symptoms of dyspepsia and gastroesophageal reflux in the community. Turk J Gastroenterol. 2007;18:14–19.PubMed Kitapcioglu G, Mandiracioglu A, Caymaz Bor C, et al. Overlap of symptoms of dyspepsia and gastroesophageal reflux in the community. Turk J Gastroenterol. 2007;18:14–19.PubMed
16.
Zurück zum Zitat Lee SY, Lee KJ, Kim SJ, et al. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196–201.CrossRefPubMed Lee SY, Lee KJ, Kim SJ, et al. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion. 2009;79:196–201.CrossRefPubMed
17.
Zurück zum Zitat Yarandi SS, Christie J. Functional dyspepsia in review: pathophysiology and challenges in the diagnosis and management due to coexisting gastroesophageal reflux disease and irritable bowel syndrome. Gastroenterol Res Pract. 2013;2013:351086.CrossRefPubMedPubMedCentral Yarandi SS, Christie J. Functional dyspepsia in review: pathophysiology and challenges in the diagnosis and management due to coexisting gastroesophageal reflux disease and irritable bowel syndrome. Gastroenterol Res Pract. 2013;2013:351086.CrossRefPubMedPubMedCentral
18.
19.
Zurück zum Zitat Hsu CS, Liu WL, Chao YC, et al. Adipocytokines and liver fibrosis stages in patients with chronic hepatitis B virus infection. Hepatol Int. 2015;9:231–242.CrossRefPubMed Hsu CS, Liu WL, Chao YC, et al. Adipocytokines and liver fibrosis stages in patients with chronic hepatitis B virus infection. Hepatol Int. 2015;9:231–242.CrossRefPubMed
20.
Zurück zum Zitat Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377–1390.CrossRefPubMed Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377–1390.CrossRefPubMed
21.
Zurück zum Zitat Buysse DJ, Reynolds CF III, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefPubMed Buysse DJ, Reynolds CF III, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefPubMed
22.
Zurück zum Zitat Lee Y, Yang MJ, Lai TJ, et al. Development of the Taiwanese Depression Questionnaire. Chang Gung Med J. 2000;23:688–694.PubMed Lee Y, Yang MJ, Lai TJ, et al. Development of the Taiwanese Depression Questionnaire. Chang Gung Med J. 2000;23:688–694.PubMed
23.
Zurück zum Zitat Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res. 2011;63:S467–S472.CrossRef Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res. 2011;63:S467–S472.CrossRef
24.
Zurück zum Zitat Hsu CS, Wang CC, Wang PC, et al. Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection. Hepatol Int. 2010;4:585–593.CrossRefPubMedPubMedCentral Hsu CS, Wang CC, Wang PC, et al. Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection. Hepatol Int. 2010;4:585–593.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111:85–92.CrossRefPubMed Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111:85–92.CrossRefPubMed
26.
Zurück zum Zitat Shaw MJ, Talley NJ, Beebe TJ, et al. Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol. 2001;96:52–57.CrossRefPubMed Shaw MJ, Talley NJ, Beebe TJ, et al. Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol. 2001;96:52–57.CrossRefPubMed
27.
Zurück zum Zitat Wang PC, Hsu CS, Tseng TC, et al. Male sex, hiatus hernia, and Helicobacter pylori infection associated with asymptomatic erosive esophagitis. J Gastroenterol Hepatol. 2012;27:586–591.CrossRefPubMed Wang PC, Hsu CS, Tseng TC, et al. Male sex, hiatus hernia, and Helicobacter pylori infection associated with asymptomatic erosive esophagitis. J Gastroenterol Hepatol. 2012;27:586–591.CrossRefPubMed
28.
Zurück zum Zitat Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–438.CrossRefPubMed Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–438.CrossRefPubMed
29.
Zurück zum Zitat Hsu CS, Wang PC, Chen JH, et al. Increasing insulin resistance is associated with increased severity and prevalence of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34:994–1004.CrossRefPubMed Hsu CS, Wang PC, Chen JH, et al. Increasing insulin resistance is associated with increased severity and prevalence of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2011;34:994–1004.CrossRefPubMed
30.
Zurück zum Zitat Gwee KA, Bak YT, Ghoshal UC, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1189–1205.CrossRefPubMed Gwee KA, Bak YT, Ghoshal UC, et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25:1189–1205.CrossRefPubMed
31.
32.
Zurück zum Zitat Mahadeva S, Goh KL. Anxiety, depression and quality of life differences between functional and organic dyspepsia. J Gastroenterol Hepatol. 2011;26:49–52.CrossRefPubMed Mahadeva S, Goh KL. Anxiety, depression and quality of life differences between functional and organic dyspepsia. J Gastroenterol Hepatol. 2011;26:49–52.CrossRefPubMed
33.
Zurück zum Zitat Hartono JL, Mahadeva S, Goh KL. Anxiety and depression in various functional gastrointestinal disorders: do differences exist? J Dig Dis. 2012;13:252–257.CrossRefPubMed Hartono JL, Mahadeva S, Goh KL. Anxiety and depression in various functional gastrointestinal disorders: do differences exist? J Dig Dis. 2012;13:252–257.CrossRefPubMed
34.
Zurück zum Zitat Ford AC, Forman D, Bailey AG, et al. The natural history of gastro-oesophageal reflux symptoms in the community and its effects on survival: a longitudinal 10-year follow-up study. Aliment Pharmacol Ther. 2013;37:323–331.CrossRefPubMed Ford AC, Forman D, Bailey AG, et al. The natural history of gastro-oesophageal reflux symptoms in the community and its effects on survival: a longitudinal 10-year follow-up study. Aliment Pharmacol Ther. 2013;37:323–331.CrossRefPubMed
35.
Zurück zum Zitat Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol. 2009;24:1601–1607.CrossRefPubMed Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol. 2009;24:1601–1607.CrossRefPubMed
36.
Zurück zum Zitat Gwee KA, Wee S, Wong ML, et al. The prevalence, symptom characteristics, and impact of irritable bowel syndrome in an Asian urban community. Am J Gastroenterol. 2004;99:924–931.CrossRefPubMed Gwee KA, Wee S, Wong ML, et al. The prevalence, symptom characteristics, and impact of irritable bowel syndrome in an Asian urban community. Am J Gastroenterol. 2004;99:924–931.CrossRefPubMed
37.
Zurück zum Zitat Greten H, Beil FU, Schneider J, et al. Treatment of primary hypercholesterolemia: fluvastatin versus bezafibrate. Am J Med. 1994;96:55S–63S.CrossRefPubMed Greten H, Beil FU, Schneider J, et al. Treatment of primary hypercholesterolemia: fluvastatin versus bezafibrate. Am J Med. 1994;96:55S–63S.CrossRefPubMed
38.
Zurück zum Zitat Gudlaugsdottir S, Verschuren W, Dees J, et al. Hypertension is frequently present in patients with reflux esophagitis or Barrett’s esophagus but not in those with non-ulcer dyspepsia. Eur J Intern Med. 2002;13:369.CrossRefPubMed Gudlaugsdottir S, Verschuren W, Dees J, et al. Hypertension is frequently present in patients with reflux esophagitis or Barrett’s esophagus but not in those with non-ulcer dyspepsia. Eur J Intern Med. 2002;13:369.CrossRefPubMed
39.
Zurück zum Zitat Anderson LA, Cantwell MM, Watson RG, et al. The association between alcohol and reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. Gastroenterology. 2009;136:799–805.CrossRefPubMed Anderson LA, Cantwell MM, Watson RG, et al. The association between alcohol and reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. Gastroenterology. 2009;136:799–805.CrossRefPubMed
40.
Zurück zum Zitat Halder SL, Locke GR III, Schleck CD, et al. Influence of alcohol consumption on IBS and dyspepsia. Neurogastroenterol Motil. 2006;18:1001–1008.CrossRefPubMed Halder SL, Locke GR III, Schleck CD, et al. Influence of alcohol consumption on IBS and dyspepsia. Neurogastroenterol Motil. 2006;18:1001–1008.CrossRefPubMed
Metadaten
Titel
Overlap of Dyspepsia in Patients with Gastroesophageal Reflux Disease: Impact of Clinical, Metabolic, and Psychosocial Characteristics
verfasst von
Ching-Sheng Hsu
Shu-Hui Wen
Jui-Sheng Hung
Tso-Tsai Liu
Chih-Hsun Yi
Wei-Yi Lei
Fabio Pace
Chien-Lin Chen
Publikationsdatum
23.01.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 4/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-017-4455-8

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