Clinical characteristics and psychosocial impact of different reflux time in gastroesophageal reflux disease patients

Jiann-Hwa Chen; Shu-Hui Wen; Ching-Sheng Hsu; Chih-Hsun Yi; Tso-Tsai Liu; Chien-Lin Chen; Chia-Chi Wang

doi:10.1016/j.jfma.2016.01.016

Clinical characteristics and psychosocial impact of different reflux time in gastroesophageal reflux disease patients

J Formos Med Assoc. 2017 Feb;116(2):123-128. doi: 10.1016/j.jfma.2016.01.016. Epub 2016 Apr 25.

Authors

Jiann-Hwa Chen¹, Shu-Hui Wen², Ching-Sheng Hsu¹, Chih-Hsun Yi³, Tso-Tsai Liu³, Chien-Lin Chen³, Chia-Chi Wang⁴

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan.
² Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan.
³ Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
⁴ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: uld888@yahoo.com.tw.

PMID: 27133182
DOI: 10.1016/j.jfma.2016.01.016

Abstract

Background/purpose: Gastroesophageal reflux disease (GERD) is an emerging disease, and can impair quality of life and sleep. This study aimed to investigate whether GERD patients with different timings of reflux symptoms have different clinical characteristics.

Methods: This study prospectively enrolled individuals who underwent upper gastrointestinal endoscopy during a health checkup. Each participant completed all questionnaires including Reflux Disease Questionnaire, Nighttime GERD questionnaire, Pittsburg Sleep Quality Index, Taiwanese Depression Questionnaire, and State-Trait Anxiety Inventory. Combined reflux was defined as the timing of reflux symptoms occurring at both daytime and nighttime.

Results: A total of 2604 participants were enrolled. Of them, 651 symptomatic GERD patients, according to the Reflux Disease Questionnaire score, were recruited for final analysis. Of them, 224 (34.4%) had erosive esophagitis on endoscopy. According to the timing of reflux symptoms, 184 (28.3%) were assigned to the daytime reflux group, 71 (10.9%) to the nighttime reflux group, and 396 (60.8%) to the combined reflux group. In post hoc analysis, the combined reflux group had a significantly higher Reflux Disease Questionnaire score than the daytime reflux group (p < 0.0001). Combined and nighttime reflux groups had higher body mass index and longer duration (> 12 years) of education than the daytime reflux group (p < 0.05). There was no difference in Pittsburg Sleep Quality Index, Taiwanese Depression Questionnaire, and State-Trait Anxiety Inventory scores among three groups.

Conclusion: GERD patients with combined daytime and nighttime reflux of have more troublesome symptoms than those with daytime reflux. GERD patients with different timings of reflux symptoms have different clinical characteristics in terms of body mass index and duration of education, but not in terms of esophageal inflammation, quality of sleep, and psychosocial status.

Keywords: body mass index; gastroesophageal reflux disease; nocturnal reflux; psychosocial status; sleep.

MeSH terms

Adult
Body Mass Index
Depression / epidemiology*
Female
Gastroesophageal Reflux / complications*
Gastroesophageal Reflux / psychology*
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Prospective Studies
Psychiatric Status Rating Scales
Quality of Life
Risk Factors
Severity of Illness Index
Sleep Wake Disorders / epidemiology*
Surveys and Questionnaires
Taiwan
Time Factors