Prevalence and associated clinical factors of Gastro-esophageal Reflux Disease in Filipino Hemodialysis patients: A cross sectional study

Introduction@#Reflux is one of the most common gastrointestinal symptoms among dialysis patients. This may be associated with several clinical factors such as comorbidities and subsequent polypharmacy. However, this remains unrecognized and untreated.@*Objectives@# The objectives of this study were to determine the prevalence of Gastroesophageal Reflux Disease (GERD) in Filipino patients on maintenance hemodialysis (HD) and to investigate associated demographic, clinical, and renal profiles of HD patients with and without GERD.@*Methods@#This was a cross-sectional, multicenter study using a validated GERD questionnaire (GERDQ) translated into Filipino. Patients above 18 years old undergoing hemodialysis as outpatients were included. Several clinical factors such as demographic, clinical, and renal profiles were analyzed based on the absence and presence of GERD with a predetermined cut-off value of eight or above.@*Results@#Included in our analysis were 264 patients, from which 36 had GERDQ score of ≥ 8 (13.64% 95%CI 9.98-18.35). Factors associated with having score of ≥ 8 included the following: (1) having chronic heart disease or CHD (COR 4.041, 95%CI 1.89-8.64, p<0.001), (2) being on insulin (COR 2.599, 95%CI 1.25-5.42, p=0.011), (3) anemia (COR 4.508, 95%CI 1.91-10.64, p=0.001) (4) diagnosis of both hypertensive kidney disease and diabetes kidney disease (COR 3.853, 95%CI 1.15-12.96, p=0.029), (5) previous diagnosis of GERD (COR 6.655, 95%CI 3.18-13.91, p<0.001), (6) previous intake of antacids (COR 2.622, 95%CI 1.17-5.89, p=0.020), (7) being employed (COR 2.332, 95%CI 1.15-4.75, p=0.020) (8) alcohol consumption (COR 2.477, 95%CI 1.23-5.01, p=0.012), and (9) smoking (COR 2.405, 95%CI 1.19-4.86, p=0.014).@*Conclusion@#In our study, the prevalence of GERD in Filipino HD patients was 13.64% and may be associated with several clinical factors such as heart disease, insulin use, anemia, hypertension, diabetic kidney disease, previous diagnosis of GERD, use of antacids, being employed, smoking, and alcohol use. A comprehensive understanding of the relationships between these clinical factors awaits further studies in a larger number of patients.

Prevalencia de síntomas del reflujo gastroesofágico y factores asociados: una encuesta poblacional en las principales ciudades de Colombia / Prevalence of Gastro-Esophageal Reflux Symptoms and Associated Factors: A Population Survey in the Principal Cities Of Colombia

Problema: el reflujo gastroesofágico es un proceso fisiológico que en algunas personas puede tornarse patológico y que produce molestias y lesiones esofágicas y extraesofágicas que afectan la calidad de vida de los individuos que lo presentan. Actualmente no se cuenta con estadísticas sobre la frecuencia de esta condición en Colombia. Objetivo: cuantificar la prevalencia de síntomas de enfermedad por reflujo gastroesofágico (ERGE) en los adultos de cuatro ciudades principales de Colombia utilizando el cuestionario GERDQ, y explorar la asociación de variables sociodemográficas y antropométricas con esta enfermedad. Metodología: estudio de corte transversal de base poblacional. Se incluyeron 6842 personas, mayores de 18 años y menores de 80 años de edad, residentes en Bogotá, Cali, Medellín y Barranquilla. La muestra fue seleccionada por muestreo aleatorio estratificado. Se aplicó una encuesta telefónica que incluía el cuestionario GERDQ para la identificación de síntomas de reflujo en la última semana. Se calculó la prevalencia de reflujo por estratos teniendo en cuenta el punto de corte de la encuesta (8 o más puntos) y se realizaron comparaciones entre ellos utilizando la prueba de x2. Se exploró la asociación de variables sociodemográficas y antropométricas mediante análisis bivariados y modelos de regresión logística. Resultados: se obtuvieron 6842 encuestas. La prevalencia estimada de síntomas de reflujo en general fue del 11,98% (IC 95%: 11,05-12,97). En el análisis por ciudades, Barranquilla presentó la frecuencia más alta (16,22%; IC 95%: 14,58-18,01) y Bogotá, la más baja (10,75; IC 95%: 9,30-12,38). Para los síntomas evaluados con el cuestionario GERDQ, la prevalencia estimada fue: pirosis, 13,6% (IC 95%: 12,50-14,60); regurgitación, 16,9% (IC 95%: 15,74-17,99); epigastralgia, 16,67% (IC 95%: 15,54-17,80): náuseas, 11,4% (IC 95%: 10,46-12,35); dificultad para dormir por presentar pirosis o regurgitación, 8,17% (IC 95%: 7,36-8,97); y consumo de medicamentos adicionales a los formulados por el médico, 6,68% (IC 95%: 6,01-7,35). El sexo femenino, el vivir en Barranquilla o Medellín y el presentar una comorbilidad se asociaron estadísticamente con la presencia de reflujo. Conclusión: la prevalencia de síntomas de reflujo en cuatro ciudades capitales de Colombia, medida con el cuestionario GERDQ, de 11,98% (IC 95%: 11,05-12,97), es similar a la reportada en otros países de Latinoamérica, siendo las comorbilidades (particularmente hipertensión arterial HTA) el factor que más se asoció con esta condición en todos los estratos del estudio

Problem: Gastroesophageal reflux is a physiological process that can become pathological in some people. It can cause discomfort and esophageal and extra-esophageal injuries and can affect the quality of life of anyone affected by it. Currently there are no statistics on the frequency of this condition in Colombia. Objective: The objective of this study was to use the GerdQ questionnaire to quantify the prevalence of gastroesophageal reflux disease in adults in four major cities of Colombia and to explore the association of sociodemographic and anthropometric variables with this disease. Methodology: This was a cross-sectional population-based study of 6,842 people between the ages of 18 years and 80 in Bogotá, Cali, Medellín and Barranquilla. The sample was selected by stratified random sampling. A telephone survey was conducted that included the GERD Q questionnaire for the identification of reflux symptoms within the week prior to an interview. The prevalence of reflux by socioeconomic strata was calculated using a cut-off point of 8 or more points. Comparisons were made among strata using the χ2 test. Associations of sociodemographic and anthropometric variables were explored through bivariate analysis and logistic regression models. Results: We obtained 6,842 surveys. The overall estimated prevalence of reflux was 11.98% (95% CI = 11.05%-12.97%). The city of Barranquilla presented the highest frequency of 16.22% (95% CI = 14.58%-18.01%) while Bogotá had the lowest of 10.75% (95% CI = 9.30%-12.38%). For symptoms evaluated with GERD-Q, the estimated prevalences were: heartburn 13.6% (95% CI = 12.50% - 14.60%), regurgitation 16.9% (95% CI = 15, 74% - 17.99%), epigastralgia 16.67% (95% CI = 15.54% -17.80%), nausea 11.4% (95% CI = 10.46% - 12.35%), difficulty sleeping due to heartburn or regurgitation 8.17% (95% CI = 7.36% -8.97%) and consumption of medications additional to those formulated by the physician 6.68% (95% CI = 6, 01% - 7.35%). Women living in Barranquilla or Medellín, had statistically significant levels of comorbidities associated with reflux. Conclusion: The prevalence of reflux in four important Colombian cities measured with the GerdQ questionnaire was 11.98% (95% CI = 11.05-12.97) which is similar to prevalences reported in other Latin American countries. Comorbidities (particularly hypertension) are the factor that was most frequently associated with this condition in all strata of the study.

Diagnostic significance and clinical characteristics of esophageal minimal change in gastroesophageal reflux disease / 中华消化杂志

Objective To evaluate the diagnostic significance of esophageal minimal change in gastroesophageal reflux disease (GERD) and explore its clinical characteristics.Methods From May to September in 2013,patients with minimal esophageal mucosa changes including esophageal mucosa rough,white secretin adhesion,erythema,edema,increased brittleness,blurring of the Z line or zigzag looking and blurring of paliform blood vessel,or patients with Los Angeles classification (LA) which were identified by endoscopy were enrolled.The subjects received gastroesophageal reflux disease questionnaire (GcrdQ) investigation and the related history were collected.The total score of GerdQ over eight was set as the criteria for GERD diagnosis.The R × C chi-square test was performed for statistical analysis.Results A total of 417 valid questionnaires were completed.Of which,202 cases were in minimal change group,176 were in LA A group and 36 were in LA-B group.The diagnostic rate of GERD in minimal change group was 20.3％ (41/202),which was lower than that of LA-A group (74.4％,131/176) and LA-B group (83.3 ％,30/36),and the differences were statistically significant (x2 =129.144,P＜0.01).The incidences of heartburn in minimal change group,LA A group and LA-B group were 25.7％ (52/202),62.5％ (110/176) and 86.1％ (31/36),respectively.The incidences of reflux were 29.7％ (60/202),67.6％ (119/176) and 75.0％ (27/36),respectively.The incidences of non cardiac chest pain were 5.4％ (11/202),22.2％ (39/176) and 22.2％(8/36),respectively.The incidences of heartburn,reflux and non cardiac chcst pain of minimal change group were all lower than those of LA A group and LA-B group,and the differences were statistically significant (x2 =75.775,64.120,24.016;all P＜0.01).The leading cause of endoscopy examination in minimal change group was abdominal discomfort,which accounted for 49.0％(99/202).The leading causes of endoscopy examination in LA A group and LA-B group were esophageal symptoms,which accounted for 52.8％ (93/176) and 61.1％ (22/36).Conclusions The diagnostic rate of GERD in patients of minimal change group is low and the clinical symptoms are not typical,which is insufficient for diagnosis of GERD and needed further investigation.

Utilidad del cuestionario GERDQ para diagnóstico de enfermedad de reflujo gastroesofágico en personal de centro médico privado en Caracas / Purpose of the GERDQ questionnaire for the diagnosis of GERD in a private center in Caracas

La enfermedad por reflujo gastroesofágico (ERGE) es una condición crónica caracterizada por el reflujo del contenido gástrico hacia el esófago, ocasionando síntomas molestos y complicaciones. Recientemente, se ha propuesto un cuestionario diagnóstico de reflujo gastroesofágico (GERDQ) con una sensibilidad del 82% y especificidad 84%, respectivamente. Determinar la utilidad del GERDQ en diagnóstico de enfermedad de reflujo gastroesofágico en un centro de salud privado de cuarto nivel. Estudio descriptivo de corte transversal, basado en la aplicación del cuestionario GERDQ a una población de 335 trabajadores personal de salud y administrativo de un centro de salud privado de cuarto nivel, de febrero a abril 2012. El registro de datos y tratamiento estadístico se hizo a través SPSS 7.5.2S para Windows. 335 individuos respondieron el cuestionario, edades comprendidas entre 18 y 60 años, se excluyeron 35, el 67% fue de género femenino, en 55 individuos (18,66%) la probalidad de ERGE fue de 0%, en 156 (52,00%) fue de 50%, en 65 (21,66%) fue de 79%, y 24 individuos (8,00%), fue 89% de probabilidad de ERGE. El GERDQ es una herramienta útil y sencilla para determinar la probabilidad diagnóstica de ERGE

Gastroesophageal reflux disease (GERD) is a condition that occurs when reflux content from the stomach is the cause of bothersome symptoms and/or complications. It can be diagnosed based on symptoms through a GERD questionnaire (GERDQ), with a reported sensibility of 82% and specificity of 84%. To determine the prevalence of GERD in a private medical center in Caracas from February to April, 2012. Descriptive, cross sectional study, based on the application of a validated questionnaire. Population was represented by the health care and administrative personnel of health care center in Caracas. 335 subjects completed the questionnaire. Ages ranged from 18 to 60 years, 35 subjects were excluded. 67% were female. In 56 (18,66%) subjects, GERD probability was 0%, in 156 (52,00%), probability was 50%, in 65 (21,66%) probability was 79% and in 24 (8,00%) subjects, probability was 89%. The GERDQ is a useful and simple tool to determine the diagnostic probability of ERGE

The gastro-esophageal reflux disease questionnaire using Indonesian language: A language validation survey.

Background: The aims of this study were to test the usefulness of the Gastro-esophageal Reflux Disease Questionnaire (GERDQ) in the diagnosis of GERD, to validate the GERDQ written in Indonesian language, and to evaluate the reliability of the GERDQ for use in Indonesian-speaking GERD patients (Virginia study). Methods: This was a prospective survey of 40 patients diagnosed with GERD, based on an endoscopic examination, in 3 cities in Indonesia (Jakarta, Bandung, and Surabaya) from 15 January to 15 May 2009. Patients were asked to complete the GERDQ, and the validity and reliability of the questionnaire were assessed. Results: The percentages of respondents who reported symptoms lasting 4–7 days were as follows: 68% had a burning sensation behind the breastbone (heartburn); 65% had stomach content (fluid) move upwards to the throat or mouth (regurgitation); 70% had a pain in the centre of the upper abdomen; 58% had nausea; 63% had difficulty sleeping because of the heartburn and/or regurgitation; and 63% took additional medication for heartburn and/or regurgitation. Cronbach’s alpha was 0.83, indicating that all of the questions in the Indonesian-language GERDQ are valid and reliable for Indonesian GERD patients. Conclusions: This study achieved the primary objectives and showed that the GERDQ is valid and reliable for use with Indonesian-speaking GERD patients. The results were consistent with those of the DIAMOND study, which showed that the GERDQ can be used to diagnose GERD on the basis of the reported symptoms.