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Determinants of symptoms in gastroesophageal reflux disease

A study in the latest issue of the European Journal of Gastroenterology & Hepatology investigates determinants of symptoms in gastroesophageal reflux disease, nonerosive reflux disease, symptomatic, and silent erosive reflux disease.

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As general checkups including endoscopy have become popular, silent erosive esophagitis, which is defined as erosive esophagitis without the typical symptoms of gastroesophageal reflux disease (GERD), is also frequently encountered.

Dr Choi, Ju Young and colleagues investigated the determinants of symptom presentation in symptomatic erosive esophagitis, nonerosive reflux disease, and silent erosive esophagitis, which are representative gastroesophageal reflux disease groups.

The team reported that participants in a prospective health-screening cohort underwent upper endoscopy from 2009 to 2010.

The research team defined gastroesophageal reflux disease as heartburn, and/or acid regurgitation at least weekly or erosive esophagitis by endoscopy.

The research team asked all participants to complete a validated questionnaire, which included questions about gastrointestinal symptoms and the somatization symptom checklist.

Among 4565 participants, gastroesophageal reflux disease was found in 678 participants, and erosive esophagitis in 335 participants.

Somatization was the most important determinant of GERD symptoms
European Journal of Gastroenterology & Hepatology

The doctors noted that each group of participants was classified into 3 categories, including symptomatic erosive esophagitis, nonerosive reflux disease, and silent erosive esophagitis.

Male sex and obesity were common predictors in both the symptomatic, and the silent erosive esophagitis groups compared with the control group.

The researchers examined that higher scores on the somatization symptom checklist and overlap of functional dyspepsia were predictors of symptomatic erosive esophagitis compared with asymptomatic erosive esophagitis.

Symptomatic erosive esophagitis was more strongly associated with male sex than was nonerosive reflux disease.

Dr Young's team concluded, "Somatization was the most important determinant of gastroesophageal reflux disease symptoms."

"Silent erosive esophagitis was prevalent among participants with gastroesophageal reflux disease, even though its natural history and clinical significance are unknown."

Euro J of Gastroenterol & Hepatol 2013: 25(7): 764-771
19 June 2013

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