The characteristics of gastroesophageal reflux disease overlapping with functional bowel diseases in gastrointestinal clinic / 中华内科杂志

ABSTRACT

Objective To analyze the common symptoms in our gastrointestinal (GI) clinic of a general hospital and the prevalence of gastroesophageal reflux disease (GERD) combined with functional bowel diseases (FBD) was also investigated.Methods Data of out-patients who visited GI clinic from April to June,2011 were collected,including demographic information and chief complaints.A validated Chinese Reflux Disease Questionnaire (RDQ) was used to assess the frequency and severity of typical gastroesophageal reflux (GER) symptoms.Reflux esophagitis (RE) and non-erosive gastroesophageal reflux disease (NERD) werc differentiated according to RDQ scores,endoscopic diagnosis,and response to proton pump inhibitors (PPIs).FBD was diagnosed based on Rome Ⅲ criteria.Results Totally 1074 patients (98.3％) had completed the questionnaires.A total of 107 patients(10％) were diagnosed as GERD among 351 patients(32.7％) who had GER symptoms.A total of 404 cases (37.6％)presented symptoms of chronic abdominal pain/bloating,chronic diarrhea/constipation.Totally 206 cases (19.2％) of FBD were diagnosed,including 63 irritable bowl disease (IBS),40 functional constipation and others.RDQ scores were positively correlated with the prevalence of other atypical GER symptoms,as well as chronic bloating,constipation,the incidence of IBS and functional constipation (FC) (P ＜ 0.05).Further,the incidences of chronic bloating[25.2％ (27/107)],chronic constipation[14.0％ (15/107)],IBS [10.3％ (11/107)] and FC[7.5％ (8/107)] in GERD patients were higher than those in non-GERD patients [16.6％(160/966),7.1％ (69/966),5.4％ (52/966),3.3％ (32/966),all P ＜0.05].Higher rate of NERD than RE overlapping with FBD was found,but without statistic significance.Conclusions GERD frequently represents with chronic bloating and constipation,usually overlaps with IBS and FC.The severity of GERD symptoms is associated with higher rate of overlapping with FBDs.