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Regurgitation influences health-related quality of life in GERD

The latest issue of Gut evaluates the impact of regurgitation on health-related quality of life in gastro-esophageal reflux disease before and after short-term potent acid suppression therapy.

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Limited data exist on the impact of regurgitation on health-related quality of life (HRQOL) in gastro-esophageal reflux disease (GERD).

Dr Peter Kahrilas and colleagues assessed the relationship between regurgitation frequency and HRQOL before and after acid suppression therapy in GERD.

The research team used data from two randomised trials of AZD0865 25–75 mg/day versus esomeprazole 20 or 40 mg/day in non-erosive reflux disease (NERD) (n=1415) or reflux esophagitis (n=1460).

The Reflux Disease Questionnaire was used to select patients with frequent and intense heartburn for inclusion and to assess treatment response.

The Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire was used to assess HRQOL.

93% of patients in both the NERD and reflux esophagitis groups experienced regurgitation
Gut

At baseline, 93% of patients in both the NERD and reflux esophagitis groups experienced regurgitation.

Mean QOLRAD scores were similar for NERD and reflux esophagitis at baseline and at week 4 and disclosed decremental HRQOL with increasing frequency of regurgitation.

The team observed a clinically relevant difference of >0.5 in mean QOLRAD scores with regurgitation ≥4 days/week versus <4 days/week.

The prevalence of frequent, persistent regurgitation at week 4 among heartburn responders was 28% in NERD, and 23% in reflux esophagitis.

The research team found that QOLRAD scores were higher among heartburn responders.

The team noted a similar pattern of impact related to regurgitation frequency in heartburn responders compared with the group as a whole.

Dr Kahrilas' team concludes, "Frequent regurgitation was associated with a clinically relevant, incremental decline in HRQOL beyond that associated with heartburn before and after potent acid suppression in both NERD and reflux esophagitis."

Gut 2014; 63: 720-726
08 April 2014

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