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Yu C, Wang T, Gao Y, Jiao Y, Jiang H, Bian Y, Wang W, Lin H, Xin L, Wang L. Association between physical activity and risk of gastroesophageal reflux disease: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:687-698. [PMID: 38552714 DOI: 10.1016/j.jshs.2024.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/02/2024] [Accepted: 02/07/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease (GERD). In response to the conflicting results in previous studies, we performed a systematic review and meta-analysis to investigate this association. METHODS Relevant studies published until January 2023 were retrieved from 6 databases, and the prevalence of symptomatic gastroesophageal reflux (GER) or GERD was determined from the original studies. A random effects model was employed to meta-analyze the association by computing the pooled relative risk (RR) with 95% confidence intervals (95%CIs). Furthermore, subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity (PA) time and GERD. RESULTS This meta-analysis included 33 studies comprising 242,850 participants. A significant negative association was observed between PA and the prevalence of symptomatic GER (RR = 0.74, 95%CI: 0.66-0.83; p < 0.01) or GERD (RR = 0.80, 95%CI: 0.76-0.84; p < 0.01), suggesting that engaging in PA might confer a protective benefit against GERD. Subgroup analyses consistently indicated the presence of this association across nearly all subgroups, particularly among the older individuals (RR<40 years:RR≥40 years = 0.85:0.69, p < 0.01) and smokers (RRsmoker:RRnon-smoker = 0.67:0.82, p = 0.03). Furthermore, a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09% lower risk of developing GERD. CONCLUSION Maintaining high levels of PA decreased the risk of GERD, particularly among older adults and smokers. Meeting the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.
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Affiliation(s)
- Chuting Yu
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Tinglu Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Ye Gao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Yunfei Jiao
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Huishan Jiang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Yan Bian
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Wei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Han Lin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China
| | - Lei Xin
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China.
| | - Luowei Wang
- Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China; National Clinical Research Center for Digestive Diseases (Shanghai), Shanghai 200433, China.
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Hungin AP, Yadlapati R, Anastasiou F, Bredenoord AJ, El Serag H, Fracasso P, Mendive JM, Savarino EV, Sifrim D, Udrescu M, Kahrilas PJ. Management advice for patients with reflux-like symptoms: an evidence-based consensus. Eur J Gastroenterol Hepatol 2024; 36:13-25. [PMID: 38006602 PMCID: PMC10695341 DOI: 10.1097/meg.0000000000002682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/11/2023] [Indexed: 11/27/2023]
Abstract
Patients with reflux-like symptoms (heartburn and regurgitation) are often not well advised on implementing individualised strategies to help control their symptoms using dietary changes, lifestyle modifications, behavioural changes or fast-acting rescue therapies. One reason for this may be the lack of emphasis in management guidelines owing to 'low-quality' evidence and a paucity of interventional studies. Thus, a panel of 11 gastroenterologists and primary care doctors used the Delphi method to develop consolidated advice for patients based on expert consensus. A steering committee selected topics for literature searches using the PubMed database, and a modified Delphi process including two online meetings and two rounds of voting was conducted to generate consensus statements based on prespecified criteria (67% voting 'strongly agree' or 'agree with minor reservation'). After expert discussion and two rounds of voting, 21 consensus statements were generated, and assigned strength of evidence and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) rating. Eleven statements achieved the strongest (100%) agreement: five are related to diet and include identification and avoidance of dietary triggers, limiting alcohol, coffee and carbonated beverages, and advising patients troubled by postprandial symptoms not to overeat; the remaining six statements concern advice around smoking cessation, weight loss, raising the head-of-the-bed, avoiding recumbency after meals, stress reduction and alginate use. The aim of developing the consensus statements is that they may serve as a foundation for tools and advice that can routinely help patients with reflux-like symptoms better understand the causes of their symptoms and manage their individual risk factors and triggers.
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Affiliation(s)
- A. Pali Hungin
- Professor Emeritus, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Rena Yadlapati
- Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
| | - Foteini Anastasiou
- 4th Local Primary Care Team, Municipality Practice and Academic Practice of Heraklion; University of Crete, Crete, Greece
| | - Albert J. Bredenoord
- Department of Gastroenterology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Hashem El Serag
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Pierluigi Fracasso
- Department of Gastroenterology and Digestive Endoscopy, Ospedale Sandro Pertini, Local Health Agency Roma 2, Rome, Italy
| | - Juan M Mendive
- La Mina Primary Care Academic Centre, Catalan Health Institute, University of Barcelona, Spain
| | - Edoardo V. Savarino
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Daniel Sifrim
- Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, UK
| | | | - Peter J Kahrilas
- Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Baroni L, Bonetto C, Solinas I, Visaggi P, Galchenko AV, Mariani L, Bottari A, Orazzini M, Guidi G, Lambiase C, Ceccarelli L, Bellini M, Savarino EV, de Bortoli N. Diets including Animal Food Are Associated with Gastroesophageal Reflux Disease. Eur J Investig Health Psychol Educ 2023; 13:2736-2746. [PMID: 38131888 PMCID: PMC10742960 DOI: 10.3390/ejihpe13120189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 12/23/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a clinical condition with a prevalence of up to 25% in Western countries. Typical GERD symptoms include heartburn and retrosternal regurgitation. Lifestyle modifications, including diet, are considered a first-line therapeutic approach. To evaluate the impact of life habits on GERD in this cross-sectional study, we used data collected through an online survey from 1146 participants. GERD was defined according to the Montreal Consensus. For all participants, clinical and lifestyle characteristics were recorded. Overall, 723 participants (63.1%) consumed a diet including animal food (non-vegans), and 423 participants (36.9%) were vegans. The prevalence of GERD was 11% (CI 95%, 9-14%) in non-vegans and 6% (CI 95%, 4-8%) in vegans. In the multivariate analysis, after adjusting for confounding factors, subjects on a non-vegan diet were associated with a two-fold increase in the prevalence of GERD compared to vegans (OR = 1.96, CI 95%, 1.22-3.17, p = 0.006). BMI and smoking habits were also significantly associated with GERD. This study shows that an animal food-based diet (meat, fish, poultry, dairy, and eggs) is associated with an increased risk of GERD compared to a vegan diet. These findings might inform the lifestyle management of patients with GERD-related symptoms.
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Affiliation(s)
- Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy;
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Irene Solinas
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Pierfrancesco Visaggi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | | | - Lucia Mariani
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Andrea Bottari
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Mattia Orazzini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Giada Guidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Christian Lambiase
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Linda Ceccarelli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Massimo Bellini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
| | - Edoardo V. Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35124 Padua, Italy;
| | - Nicola de Bortoli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (I.S.); (P.V.); (L.M.); (A.B.); (M.O.); (G.G.); (L.C.); (M.B.); (N.d.B.)
- NUTRAFOOD, Interdepartmental Center for Nutraceutical Research and Nutrition for Health, University of Pisa, 56124 Pisa, Italy
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Rizzo G, Baroni L, Bonetto C, Visaggi P, Orazzini M, Solinas I, Guidi G, Pugliese J, Scaramuzza G, Ovidi F, Buselli I, Bellini M, Savarino EV, de Bortoli N. The Role of a Plant-Only (Vegan) Diet in Gastroesophageal Reflux Disease: Online Survey of the Italian General Population. Nutrients 2023; 15:4725. [PMID: 38004119 PMCID: PMC10674515 DOI: 10.3390/nu15224725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The relationship between food and the pathophysiological mechanisms of gastroesophageal reflux disease (GERD) is unclear. There are few data on the impact of dietary habits on GERD symptoms and on the incidence of GERD in subjects undergoing plant-based diets. In this study, we investigated the association between diet and GERD, using data collected through an online survey of the Italian general population. In total, 1077 subjects participated in the study. GERD was defined according to the Montreal Consensus. For all subjects age, gender, body mass index (BMI), marital status, education, occupation, alcohol consumption, and smoking habits were recorded. All participants also completed the SF-36 questionnaire on Quality of Life. A total of 402 subjects (37.3%) were vegans and 675 (62.7%) non-vegans. The prevalence of GERD in the total population was 9%. Subjects with GERD-related symptoms recorded a worse quality of life according to SF-36 analysis (p < 0.05 for all dimensions). In multivariate analysis, after adjusting for confounders, participants undergoing a vegan diet had a significantly lower risk of GERD (OR = 0.47, 95% CI 0.28-0.81, p = 0.006). These findings should be taken into account to inform the lifestyle management of GERD.
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Affiliation(s)
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, 30171 Venice, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Pierfrancesco Visaggi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Mattia Orazzini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Irene Solinas
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Giada Guidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Jessica Pugliese
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Giulia Scaramuzza
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Filippo Ovidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Irene Buselli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Massimo Bellini
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
| | - Edoardo V. Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35124 Padua, Italy;
| | - Nicola de Bortoli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (P.V.); (M.O.); (I.S.); (G.G.); (J.P.); (G.S.); (F.O.); (I.B.); (M.B.); (N.d.B.)
- NUTRAFOOD, Interdepartmental Center for Nutraceutical Research and Nutrition for Health, University of Pisa, 56124 Pisa, Italy
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Morita A, Horiuchi A, Ota H, Horiuchi I, Takada H. Rising Trends of Endoscopic Barrett's Esophagus and Gastric Fundic Gland Polyps in Young Japanese Adults. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2023; 34:925-931. [PMID: 37485560 PMCID: PMC10544187 DOI: 10.5152/tjg.2023.22533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/13/2022] [Indexed: 07/25/2023]
Abstract
BACKGROUND/AIMS This study examined changes in the esophageal-gastric junction and gastric mucosa in young Japanese adults undergoing endoscopy in the last 15 years. MATERIALS AND METHODS This was a retrospective study of young Japanese adults (aged 19-30 years) who underwent esophagogastrod uodenoscopy between 2006 and 2020. The indications were upper gastrointestinal symptoms and anemia. Changes in the appearance of the esophago-gastric junction (i.e., the Z line and distal esophagitis) and gastric mucosa were examined. Endoscopic Barrett's esophagus was defined using the Japanese criteria. RESULTS One thousand eight hundred forty-five patients were examined: 848 from 2006 to 2012 [400 males, mean age 26.5 years (range 19-30)] and 997 from 2013 to 2020 [433 males, mean age 26.2 years (range 19-30)]. The proportion showing endoscopic Barrett's esophagus and gastric fundic gland polyps increased significantly between the 2 periods (12.5% vs. 22.4%, P < .001; 3.4% vs. 7.2%, P < .001) with a significant correlation between the prevalence trends for endoscopic Barrett's esophagus and gastric fundic gland polyps (r = 0.789, P = .0008). Pathological examination showed that the prevalence of traditional fundic gland polyps unrelated to the use of proton pump inhibitors significantly increased from 40% (4/10) to 81% (25/31) between the 2 periods (P = .04). CONCLUSION The prevalence of both endoscopic Barrett's esophagus and gastric fundic gland polyps among young Japanese adults significantly increased in the last 15 years. The trend in endoscopic Barrett's esophagus was significantly correlated with that of nonproton pump inhibitor-related gastric fundic gland polyps.
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Affiliation(s)
- Atushi Morita
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Akira Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Hiroyoshi Ota
- Department of Biomedical Laboratory Medicine, Shinshu University Faculty of Medicine, Matsumoto, Japan
| | - Ichitaro Horiuchi
- Department of Gastroenterology, Shinshu University Faculty of Medicine, Matsumoto, Japan
| | - Hidetosi Takada
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
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Li Q, Li FR, Zhen S, Liao J, Wu K, Li X, Wei B, Xiao Z, Wu Q, Wu XB, Liang F. Shift work and risk of incident gastroesophageal reflux disease: the association and mediation. Front Public Health 2023; 11:1192517. [PMID: 37693713 PMCID: PMC10483823 DOI: 10.3389/fpubh.2023.1192517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Shift work has become an increasingly common work mode globally. This study aimed to investigate the association between shift work and the risk of incident gastroesophageal reflux disease (GORD), an upward gastrointestinal disorder disease worldwide, and to explore the mediating factors. Method A total of 262,722 participants from the UK Biobank free of GORD and related gastrointestinal diseases were included to investigate the association and potential mediators between shift work and incident GORD. Multivariate-adjusted Cox models were used to evaluate the association between shift work status and GORD incidence. Results Compared to non-shift workers, shift workers had a 1.10-fold greater risk of incident GORD [95% confidence intervals (CIs): 1.03, 1.18], after adjusting for a range of potential confounders. However, the excess risk of GORD attenuated to the null after further adjusting for selected mediators. Specifically, the association was mediated by sleep patterns (25.7%), healthy behaviors (16.8%), depressive symptoms (20.2%), chronic conditions (13.3%), and biological factors (17.6%). After adjustment for all the mediators together, the association was attenuated by 71.5%. Discussion Our findings indicated that long-term shift workers may have a higher risk of incident GORD, yet the excess risk may be explained by poor sleep quality, unhealthy behaviors, depressive symptoms, etc. This has positive implications for protecting the health of shift workers.
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Affiliation(s)
- Qian Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Shihan Zhen
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Jian Liao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Keye Wu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Xia Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Bincai Wei
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Zhiyi Xiao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Qingyao Wu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
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Shiota S, Shibata A, Horinouchi N, Yamamoto K, Miyazaki E. Lifestyle Factors Associated With Erosive Esophagitis in Japanese Individuals With and Without Obesity Undergoing Health Checkups. J Prim Care Community Health 2023; 14:21501319231205383. [PMID: 37846060 PMCID: PMC10583521 DOI: 10.1177/21501319231205383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Several lifestyle factors have been reported to be associated with erosive esophagitis (EE). Many studies examined the associated factors for EE independent of obesity. However, lifestyle factors associated with EE might differ depending on sex or the presence of obesity. This study thus aimed to investigate the lifestyle risk factors for EE stratified by obesity and sex. METHODS A cross-sectional survey was conducted among Japanese people who underwent an annual health checkup at the Oita Health Checkup Center between 2019 and 2021. Multivariate analysis was performed to determine the factors associated with EE in participants stratified by sex and the presence of obesity. RESULTS EE was diagnosed in 676 of 5240 participants (12.9%) who were analyzed, and occurred most often in males (601 cases). The percentage of obesity based on body mass index was significantly higher among EE than non-EE participants (50.3% and 26.5%, P < .001). In obese males, eating just before bedtime (OR = 1.34, 95% CI 1.01-1.78) and hiatal hernia (OR = 3.42, 95% CI 2.57-4.54) were significantly associated with EE in multivariate analysis. In non-obese males, current smoking (OR = 1.48, 95% CI 1.07-2.04), alcohol consumption of 40 to 60 g/day (OR = 1.60, 95% CI 1.11-2.30), and hiatal hernia (OR = 3.63, 95% CI 2.79-4.73) were significantly associated with EE. CONCLUSIONS We found that factors associated with EE were different between obese and non-obese males. In obese males, avoiding going to bed within 2 h after dinner might contribute to preventing the occurrence of EE. In non-obese males, prevention of obesity, quitting smoking, and avoiding heavy alcohol consumption might be important for preventing the development of EE.
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Affiliation(s)
- Seiji Shiota
- Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Aika Shibata
- Oita University Faculty of Medicine, Yufu, Oita, Japan
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N-3 polyunsaturated fatty acids protect esophageal epithelial cells from acid exposure. Food Res Int 2022; 162:111943. [DOI: 10.1016/j.foodres.2022.111943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/20/2022] [Accepted: 09/12/2022] [Indexed: 11/18/2022]
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Chen Y, Chen C, Ouyang Z, Duan C, Liu J, Hou X, Bai T. Prevalence and beverage-related risk factors of gastroesophageal reflux disease: An original study in Chinese college freshmen, a systemic review and meta-analysis. Neurogastroenterol Motil 2022; 34:e14266. [PMID: 34585480 DOI: 10.1111/nmo.14266] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/06/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Beverage-drinking behavior could be a potential risk factor for gastroesophageal reflux disease (GERD) in young populations. However, GERD prevalence in this population has not been investigated, and beverage consumption's association with GERD remains inconclusive. This study aimed to evaluate the prevalence and beverage-related risk factors of GERD among Chinese college freshmen and in youth around the world. METHODS A cross-sectional survey was conducted in Chinese college freshmen in September 2019 using random cluster sampling method. Participants completed questionnaires on demographic information, food intake frequency, and GER symptoms. Multivariate logistic regression models were applied to assess the association between beverages and GERD. Studies were retrieved from multiple databases for systemic review. The prevalence of GERD in young populations and beverage-related risk factors were pooled using random-effect models. KEY RESULTS Based on the 3345 individuals who completed the questionnaires, GERD prevalence in Chinese college freshmen is 5.1%. Multivariate analysis showed students who drink green tea daily, and those who drink coffee regularly were more likely to develop GERD compared with those who never drink tea or coffee. The pooled prevalence of GERD in young populations is 18.0%, and frequent alcohol consumption is positively associated with GERD in general population. CONCLUSIONS AND INFERENCES The prevalence of GERD in Chinese college freshmen is significantly lower than that in worldwide youth populations. Alcohol, green tea, and coffee consumption could be potential risk factors for GERD. Future large-scale epidemiological studies are warranted for reliable identification of beverage-related risk factors for GERD in young populations.
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Affiliation(s)
- Youli Chen
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Can Chen
- Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Ouyang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaofan Duan
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsong Liu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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The association between laryngopharyngeal reflux and insomnia. Eur Arch Otorhinolaryngol 2022; 279:3535-3541. [PMID: 35129631 DOI: 10.1007/s00405-022-07280-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the prevalence of insomnia in patients with laryngopharyngeal reflux (LPR) and to analyze the relationship between the severity of insomnia and LPR-related symptoms. METHODS We analyzed 69 patients with LPR and 61 healthy controls. The LPR was confirmed via the 24-h hypopharyngeal-esophageal multichannel intraluminal impedance pH monitoring. Reflux symptoms and sleep disturbances were assessed using the Reflux Symptom Index and Insomnia Severity Index. We compared the prevalence of insomnia between the two groups. We analyzed the relationship between reflux symptoms and severity of insomnia. RESULTS The prevalence of insomnia was significantly higher in patients with LPR than in healthy controls (46.3% vs. 29.5%; p = 0.049). The severity of reflux-related symptoms was correlated with insomnia severity (rho = 0.44; p < 0.001). Patients with LPR with nighttime reflux were more likely to have sleep disturbances than patients with LPR without nighttime reflux. CONCLUSION Patients with LPR are more likely to experience insomnia than healthy controls, and the severity of reflux symptoms was related to the severity of insomnia.
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11
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Manabe N, Matsueda K, Haruma K. Epidemiological Review of Gastroesophageal Junction Adenocarcinoma in Asian Countries. Digestion 2022; 103:29-36. [PMID: 34718236 DOI: 10.1159/000519602] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/13/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Similar trends in the prevalence of gastroesophageal reflux disease (GERD), obesity, and Helicobacter pylori infection have been observed in Asian and Western countries despite their time differences. However, it is unclear whether the prevalence of gastroesophageal junction adenocarcinomas in Asian countries is increasing. In this review, we discuss the epidemiological trends of gastroesophageal junction adenocarcinoma in Asian countries. SUMMARY The prevalence of GERD is increasing in Asian countries, but most cases are considered mild. Obesity is a serious problem worldwide, but it is considered less serious in Asia than in Western countries. In Asian countries where gastric cancer is common, both cardiac and noncardiac cancers are associated with high rates of H. pylori infection, which is considered a carcinogenic risk factor for both sites of cancer. The widespread use of H. pylori eradication therapy for chronic gastritis in several Asian countries has not directly led to an increased prevalence of esophageal adenocarcinoma. One of the originating sites of junctional adenocarcinoma in most Asian countries is Barrett's esophagus, with short-segment Barrett's esophagus having much lower carcinogenicity than long-segment Barrett's esophagus. Key Messages: Considering the future trends of several risk factors for gastroesophageal junction adenocarcinoma in Asian countries, it is likely that the incidence of gastroesophageal junction adenocarcinoma will gradually increase, but not at a rate that exceeds that of squamous cell carcinoma, as in Western countries.
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Affiliation(s)
- Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School, Okayama, Japan
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12
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Association between sitting-time at work and incidence of erosive esophagitis diagnosed by esophagogastroduodenoscopy: a Korean cohort study. Ann Occup Environ Med 2022; 34:e15. [PMID: 36093267 PMCID: PMC9436792 DOI: 10.35371/aoem.2022.34.e15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/28/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background Most previous longitudinal studies on lifestyle and gastroesophageal reflux disease (GERD) have focused on physical activity rather than sitting time. The main purpose of this study was to investigate the relationship between prolonged sitting time and the development of erosive esophagitis (EE). Methods A self-report questionnaire was used for measuring sitting time in the Kangbuk Samsung Health Study. Sitting time was categorized into four groups: ≤ 6, 7–8, 9–10, and ≥ 11 hours/day. Esophagogastroduodenoscopy (EGD) was performed by experienced endoscopists who were unawared of the aims of this study. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of EE were estimated using Cox proportional hazards analyses with ≤ 6 hours/day sitting time as the reference. Results There were 6,524 participants included in the study. During a mean follow-up of 3.14 years, 2,048 incident cases developed EE. In age- and sex-adjusted models, the HR in the group sitting ≥ 11 hours per day compared ≤ 6 hours per day was 0.88 (95% CI: 0.76–0.99). After further adjusting for alcohol intake, smoking status, educational level, history of diabetes, and history of dyslipidemia, sitting time was still significantly related to the risk of EE (HR, 0.87; 95% CI: 0.76–0.98). After further adjustment for exercise frequency, this association persisted (HR, 0.86; 95% CI: 0.76–0.98). In subgroup analysis by obesity, the relationship between sitting time and EE was only significant among participants with body mass index < 25 kg/m2 (HR, 0.82; 95% CI: 0.71–0.95). Conclusions Generally, prolonged sitting time is harmful to health, but with regard to EE, it is difficult to conclude that this is the case.
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Roux-en-Y Reconstruction Following Distal Gastrectomy Reduced Endoscopic Reflux Esophagitis in Older Adults: Propensity Score–Matching Analysis. Int Surg 2021. [DOI: 10.9738/intsurg-d-20-00045.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective
This study aimed to examine the functional outcomes of Roux-en-Y (RY) and Billroth I (BI) reconstruction methods following distal gastrectomy in patients ages ≥75 years with gastric cancer.
Summary of background data
RY and BI reconstructions are commonly performed after distal gastrectomy. However, no study has compared the 2 procedures in older adults.
Methods
We identified older patients who underwent RY (n = 103) or BI (n = 71) reconstruction following distal gastrectomy from 2011 to 2018 in our database. Patients in the RY and BI groups were matched by propensity scores, and each group included 62 patients. We compared short-term surgical outcomes and clinical findings at 1 year postoperatively. Additionally, risk factors for endoscopic reflux esophagitis following distal gastrectomy were evaluated.
Results
Reflux esophagitis, bile reflux, and remnant gastritis were significantly less frequent in RY reconstruction than in BI reconstruction. Moreover, both BI reconstruction and preoperative hiatus hernias were independent risk factors for postoperative endoscopic reflux esophagitis. Although the incidence of postoperative surgical complications following RY and BI was similar, RY was found to cause delayed gastric emptying more frequently than BI.
Conclusion
RY reconstruction is a favorable procedure to prevent reflux esophagitis in older patients, particularly in those with hiatal hernia.
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14
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Osaga S, Nakada K, Iwakiri K, Haruma K, Joh T, Kamiya T. Sex differences in risk factors for future onset of reflux esophagitis. J Clin Biochem Nutr 2021; 69:91-97. [PMID: 34376918 PMCID: PMC8325768 DOI: 10.3164/jcbn.20-202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/25/2020] [Indexed: 11/25/2022] Open
Abstract
Reflux esophagitis is known to be more prevalent in males, and previous studies have suggested sex differences in its risk factors. However, little is known about sex differences in the time-course of risk factors before reflux esophagitis onset. Thus, we conducted a retrospective longitudinal study using health checkup records. From the records of 230,056 individuals obtained from nine institutes in Japan, we selected 1,558 male reflux esophagitis cases, 3,116 male controls, 508 female reflux esophagitis cases, and 1,016 female controls were selected. We compared time-courses of risk factors between the case and control groups and identified abdominal circumference (AC), diastolic blood pressure, alanine transaminase (ALT), and current smoking in males and body mass index (BMI) in females as sex-specific risk factors. We also found that AC and ALT in males and BMI in females were significantly different between the reflux esophagitis case and control groups during the five years before reflux esophagitis onset. Our results suggest that visceral fat-type obesity and fatty liver in males and higher BMI in females are more frequently observed in reflux esophagitis cases several years before reflux esophagitis onset, and that proactive intervention to lifestyle can help prevent reflux esophagitis in both males and females.
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Affiliation(s)
- Satoshi Osaga
- Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Koji Nakada
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Katsuhiko Iwakiri
- Department of Gastroenterology, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Okayama 700-8505, Japan
| | - Takashi Joh
- Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Takeshi Kamiya
- Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
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Alsaleem MA, Awadalla NJ, Shehata SF, Saeed Alsamghan A, AlFlan MA, Alhumaidi MM, Alwadai MS, Althabet FS, Alzahrani MS, Alsaleem SA, Mahfouz AA. Prevalence and factors associated with gastroesophageal reflux disease among primary health care attendants at Abha city, southwestern Saudi Arabia. Saudi Pharm J 2021; 29:597-602. [PMID: 34194266 PMCID: PMC8233534 DOI: 10.1016/j.jsps.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is an abnormal reflux of the gastric content into the esophagus. In Saudi Arabia the GERD prevalence is not recently well studied. OBJECTIVE To investigate the prevalence of gastroesophageal reflux disease and associated factors among attendants of primary health care centers (PHCCs) at Abha city, Saudi Arabia. METHOD A descriptive cross- sectional study was performed using GerdQ as diagnostic tool for the GERD. The GerdQ consisted of six questions. Four questions were about the positive GERD predictors. The other two questions were about the negative GERD predictors. The scoring of GerdQ relies on the frequency of GERD symptoms during the last seven days. Using stratified random sample technique a representative sample was slected from the study PHCCs taking into conmsideration the relative catchment population in each center among adult males and females attending the selected PHCCs for any reason. RESULTS The present study included 320 persons. The study showed a prevalence of GERD of 67.8%. The prevalence of GERD with high impact on daily life (HIDL) was found to be 50%. By multiple logistic regression (enter method) only four significant independent factors associated with GERD were identified; being unmarried (aOR = 1.85, 95% CI:1.02-3.23); smoking (aOR = 2.11, 95% CI: 1.41-5.98), fast food intake (OR = 1.28, 95% CI:1.01-1.71), and subjective perception of stress (OR = 3.0, 95% CI:1.68-5.26). CONCLUSIONS GERD is a public health problem among adults in the region. Community level awareness programs are recommended. Healthcare providers must be aware of community perceptions and practices.
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Affiliation(s)
- Mohammed A. Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Nabil J. Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Shehata F. Shehata
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt
| | - Awad Saeed Alsamghan
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammed A. AlFlan
- Medical Intern, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Marwan M. Alhumaidi
- Medical Intern, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohamed S. Alwadai
- Medical Intern, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Fahad S. Althabet
- Medical Intern, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohamad S. Alzahrani
- Medical Intern, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Safar A. Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ahmed A. Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt
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16
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Zhang M, Hou ZK, Huang ZB, Chen XL, Liu FB. Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review. Ther Clin Risk Manag 2021; 17:305-323. [PMID: 33883899 PMCID: PMC8055252 DOI: 10.2147/tcrm.s296680] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/17/2021] [Indexed: 01/30/2023] Open
Abstract
We performed this review to clarify which dietary and lifestyle factors are related to gastroesophageal reflux disease. Through a systematic search of the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature (CBM) databases, we identified articles with clear definitions of GERD, including nonerosive gastroesophageal reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), that included dietary and lifestyle factors as independent factors affecting the onset of GERD (expressed as odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs)). Due to heterogeneity among the studies, we used descriptive statistical analyses to analyze and synthesize each outcome based on the disease type. In total, 72 articles were included, conducted in ten Western countries (26 articles in total) and nine Eastern countries (46 articles in total). We categorized dietary factors into 20 items and lifestyle factors into 11 items. GERD is related to many irregular dietary and lifestyle habits (such as a habit of midnight snacking: OR=5.08, 95% CI 4.03–6.4; skipping breakfast: OR=2.7, 95% CI 2.17–3.35; eating quickly: OR=4.06, 95% CI 3.11–5.29; eating very hot foods: OR=1.81, 95% CI 1.37–2.4; and eating beyond fullness: OR=2.85, 95% CI 2.18–3.73). Vegetarian diets (consumption of nonvegetarian food (no/yes); OR=0.34, 95% CI 0.211–0.545) and no intake of meat (OR=0.841, 95% CI 0.715–0.990) were negatively related to GERD, while meat (daily meat, fish, and egg intake: OR=1.088, 95% CI 1.042-1.135) and fat (high–fat diet: OR=7.568, 95% CI 4.557–8.908) consumption were positively related to GERD. An interval of less than three hours between dinner and bedtime (OR=7.45, 95% CI 3.38–16.4) was positively related to GERD, and proper physical exercise (physical exercise >30 minutes (>3 times/week): OR=0.7, 95% CI 0.6–0.9) was negatively correlated with GERD. Smoking (OR=1.19, 95% CI 1.12–1.264), alcohol consumption (OR=1.278, 95% CI 1.207–1.353) and mental state (poor mental state: OR=1.278, 95% CI 1.207–1.353) were positively correlated with GERD. RE (vitamin C: OR=0.46, 95% CI=0.24–0.90) and BE (vitamin C: OR=0.44,95% CI 0.2-0.98; vitamin E: OR=0.46, 95% CI 0.26–0.83) were generally negatively correlated with antioxidant intake. In conclusion, many dietary and lifestyle factors affect the onset of GERD, and these factors differ among regions and disease types. These findings need to be further confirmed in subsequent studies.
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Affiliation(s)
- Mei Zhang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zheng-Kun Hou
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhi-Bang Huang
- Graduate College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xin-Lin Chen
- Department of Preventive Medicine and Health Statistics, College of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Feng-Bin Liu
- Gastroenterology Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,Baiyun Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Sogabe M, Okahisa T, Kurihara T, Kagawa M, Kagemoto K, Kida Y, Tomonari T, Taniguchi T, Okamoto K, Miyamoto H, Sato Y, Nakasono M, Takayama T. Differences in Several Factors in the Development of Erosive Esophagitis Among Patients at Various Stages of Metabolic Syndrome: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:1589-1600. [PMID: 33883913 PMCID: PMC8054472 DOI: 10.2147/dmso.s298326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Erosive esophagitis (EE) is strongly associated with metabolic syndrome (MS), but is not always recognized in individuals with MS and the prevalence of EE in individuals with non-MS is not low. AIM To examine the differences in clinical factors associated with EE at various stages of MS, as well as the differences in metabolites between subjects with MS, with and without EE. METHODS A total of 7,097 persons who underwent health checkups including esophagogastroduodenoscopy were analyzed. We examined the differences in clinical factors for EE among subjects with non-MS, pre-MS, and MS and compared metabolites between 34 subjects with MS, with and without EE. RESULTS EE prevalence was significantly higher in the MS and pre-MS groups than in the non-MS group (p < 0.001). EE severity was higher in the MS group than in the pre-MS and non-MS groups (p < 0.001). In the non-MS group, there were significant differences between subjects with and without EE with respect to Helicobacter pylori (H. pylori) and smoking. In the pre-MS and MS groups, there were significant differences in H. pylori, hiatal hernia, and drinking in those with and without EE. The levels of glutamine, hypoxanthine, and lactic acid metabolites were significantly different between subjects with MS, with and without EE (all p < 0.05). CONCLUSION Although H. pylori and lifestyle factors such as smoking and drinking are important for EE, differences in these factors should be considered at various stages of MS. Additionally, several metabolites may be involved in the development of EE in MS.
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Affiliation(s)
- Masahiro Sogabe
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo, Japan
| | - Toshiya Okahisa
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo, Japan
| | - Takeshi Kurihara
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo, Japan
| | - Miwako Kagawa
- Department of Internal Medicine, Shikoku Central Hospital of the Mutual Aid Association of Public School Teachers, Shikokuchuo, Japan
| | - Kaizo Kagemoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoshifumi Kida
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tetsu Tomonari
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tatsuya Taniguchi
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Koichi Okamoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiroshi Miyamoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yasushi Sato
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masahiko Nakasono
- Department of Internal Medicine, Tsurugi Municipal Handa Hospital, Tsurugi, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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18
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Wenzl EM, Riedl R, Borenich A, Petritsch W, Wenzl HH. Low prevalence of gastroesophageal reflux symptoms in vegetarians. Indian J Gastroenterol 2021; 40:154-161. [PMID: 33846945 DOI: 10.1007/s12664-021-01156-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Dietary modification could reduce the risk of gastroesophageal reflux disease. Circumstantial evidence suggests that gastroesophageal reflux is less prevalent in people adhering to a vegetarian diet. We aimed to study the relationship between vegetarianism and the occurrence of gastroesophageal reflux symptoms (GERS). METHODS This study compares the prevalence of GERS in vegetarians with non-vegetarian controls from the general population. Frequency and severity of GERS (heartburn and/or acid regurgitation) were assessed with a self-administrated questionnaire. RESULTS Within 1 year, any GERS were experienced by 19 of 100 (19%) vegetarians and by 98 of 250 (39.2%) non-vegetarian controls (p < 0.001). Frequent GERS, defined as GERS on at least 1 day per week, were noted in 3% of vegetarians and in 12.8% of controls (p = 0.006). Reflux symptoms were significantly less severe in vegetarians than in non-vegetarians (p < 0.001). According to multivariable analysis, independent predictors of GERS included male sex, current smoking, BMI ≥ 25 (odds ratio [OR] = 1.94; 95% confidence interval [CI], 1.14-3.31), and a non-vegetarian diet (OR = 2.19; 95% CI, 1.20-3.97); non-vegetarian diet independently predicted frequent GERS (OR 4.03; 95% CI, 1.17-13.9). An increased risk of GERS (OR = 2.17; 95% CI, 1.09-4.29) and frequent GERS (OR 4.00; 95% CI, 1.13-14.18) in non-vegetarians were also demonstrated by logistic regression of matched data. In non-vegetarians, the risk of reflux symptoms was not significantly related to meat intake. CONCLUSIONS The prevalence and severity of GERS are lower in vegetarians than in non-vegetarians from the general population. The results are in line with a mitigating effect of vegetarianism on GERS. Data must be interpreted with caution given the retrospective study design and the small sample size.
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Affiliation(s)
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Andrea Borenich
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Wolfgang Petritsch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Heimo H Wenzl
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Isshi K, Matsuhashi N, Joh T, Higuchi K, Iwakiri K, Kamiya T, Manabe N, Nakada T, Ogawa M, Arihiro S, Haruma K, Nakada K. Clinical features and therapeutic responses to proton pump inhibitor in patients with severe reflux esophagitis: A multicenter prospective observational study. JGH Open 2021; 5:99-106. [PMID: 33490619 PMCID: PMC7812480 DOI: 10.1002/jgh3.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
Background and Aim In patients with severe erosive reflux disease (ERD; Los Angeles classification grade C/D) who do not undergo endoscopic examination, insufficient strength and duration of proton pump inhibitor (PPI) therapy may lead to complications such as esophageal bleeding and stenosis. Therefore, to provide a safe and effective treatment for gastroesophageal reflux disease (GERD), we investigated the clinical features of patients with severe ERD and their responses to PPI therapy. Methods Patients with GERD symptoms received PPI therapy for 4 weeks after endoscopic examination. The patients completed the Gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test questionnaire before and 2 or 4 weeks after PPI treatment. Patient characteristics, presence/absence of coexisting atrophic gastritis (AG) and hiatus hernia (HH), and responses to PPI therapy were compared in patients with GERD among three groups (nonerosive reflux disease, mild ERD [grade A/B], and severe ERD). Results The severe ERD group had a significantly higher proportion of males, higher body mass index, and longer duration of GERD morbidity. Furthermore, the severe ERD group also had a significantly lower incidence of coexisting AG and higher incidence of HH. There was no difference in the severity of GERD before PPI treatment among the three groups. Unexpectedly, the response to PPI therapy was the best in the severe ERD group. Conclusion Sufficient strength and period of PPI therapy are required, even if the symptoms show early improvement, when treating GERD patients without performing endoscopy, considering the possibility of severe ERD.
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Affiliation(s)
- Kimio Isshi
- Department of Gastroenterology Isshi Gastro‐Intestinal Clinic 2‐15‐21, Shinozaki‐cho Edogawa‐Ku 133‐0061 Tokyo Japan
- Department of Endoscopy The Jikei University School of Medicine 3‐15‐8, Nishishinbashi Minato‐Ku 105‐8461 Tokyo Japan
| | - Nobuyuki Matsuhashi
- Department of Gastroenterology NTT Medical Center Tokyo 5‐9‐22, Higashi‐Gotanda Shinagawa‐Ku 144‐8625 Tokyo Japan
| | - Takashi Joh
- Department of Gastroenterology Gamagori City Hospital 1‐1, Mukaida Hirata‐cho Gamagori 443‐8501 Aichi Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine Osaka Medical College 2‐7, Daigakumachi Takatsuki 569‐8686 Osaka Japan
| | - Katsuhiko Iwakiri
- Department of Gastroenterology Nippon Medical School Graduate School of Medicine 1‐1‐5, Sendagi Bunkyo‐Ku 133‐8603 Tokyo Japan
| | - Takeshi Kamiya
- Department of Medical Innovation Nagoya City University Graduate School Medical Sciences 1, Kwasumi Mizuhocho, Mizuho‐Ku Nagoya 467‐8601 Aichi Japan
| | - Noriaki Manabe
- Division of Endoscopy and Ultrasonography, Department of Laboratory Medicine Kawasaki Medical School 2‐6‐1, Nakasange, Kita‐Ku Okayama 700‐8505 Okayama Japan
| | - Tatsuya Nakada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Katsushika Medical Center, The Jikei University School of Medicine 6‐41‐2, Aoto Katsushika‐Ku 125‐8506 Tokyo Japan
| | - Maiko Ogawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Katsushika Medical Center, The Jikei University School of Medicine 6‐41‐2, Aoto Katsushika‐Ku 125‐8506 Tokyo Japan
| | - Seiji Arihiro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine Katsushika Medical Center, The Jikei University School of Medicine 6‐41‐2, Aoto Katsushika‐Ku 125‐8506 Tokyo Japan
| | - Ken Haruma
- Department of General Internal Medicine 2 Kawasaki Medical School Kawasaki Hospital 577, Matsushima Kurashiki 701‐0192 Okayama Japan
| | - Koji Nakada
- Department of Laboratory Medicine The Jikei University School of Medicine 3‐25‐8, Nishishinbashi Minato‐Ku 105‐8461 Tokyo Japan
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20
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Kusakari M, Nakayama Y, Horiuchi A, Nakazawa Y. Trends in gastroesophageal reflux disease in Japanese children and adolescents. Pediatr Int 2020; 62:1269-1274. [PMID: 32473087 DOI: 10.1111/ped.14324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/11/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although the prevalence of gastroesophageal reflux disease (GERD) has been increasing in Japan, little is known about the prevalence and severity of GERD in pediatric patients. This study compared the prevalence and severity of endoscopically proven GERD in pediatric patients seen at an endoscopy center in Japan over a 15-year period. METHODS This was a retrospective chart review of Japanese children aged 5-18 years undergoing esophagogastroduodenoscopy for upper gastrointestinal symptoms or anemia between 2005 and 2019. The prevalence and severity of reflux esophagitis and endoscopic Barrett's esophagus were compared between the periods 2005-2012 and 2013-2019. RESULTS A total of 564 patients were evaluated: 315 from 2005 to 2012 (mean ± SD) age 13.8 ± 3.0 (range, 5-18 years; 147 boys; and 249 from 2013 to 2019 (mean ± SD) 14.7 ± 2.8 (range, 5-18) years; 108 boys. Demographics and clinical features were similar between the two groups. The proportion with erosive esophagitis or endoscopic Barrett's esophagus increased significantly between the two periods (9.8% to 18.1% for GERD, P = 0.0045 and 2.5% to 9.6% for Barrett's esophagus, P = 0.0003). The proportion of GERD patients with endoscopic Barrett's esophagus also significantly increased between the two periods (24/45 [53.3%]) vs (8/31 [25.8%]), P = 0.017]. CONCLUSION The prevalence and severity of endoscopically proven GERDs has significantly increased over the past 15 years at an endoscopy center in Japan. Detailed population-based studies are needed to assess whether this is occurring throughout Japan.
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Affiliation(s)
- Mai Kusakari
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.,Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.,Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Akira Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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21
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Impacts of Green Tea on Joint and Skeletal Muscle Health: Prospects of Translational Nutrition. Antioxidants (Basel) 2020; 9:antiox9111050. [PMID: 33126483 PMCID: PMC7692648 DOI: 10.3390/antiox9111050] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Osteoarthritis and sarcopenia are two major joint and skeletal muscle diseases prevalent during aging. Osteoarthritis is a multifactorial progressive degenerative and inflammatory disorder of articular cartilage. Cartilage protection and pain management are the two most important strategies in the management of osteoarthritis. Sarcopenia, a condition of loss of muscle mass and strength, is associated with impaired neuromuscular innervation, the transition of skeletal muscle fiber type, and reduced muscle regenerative capacity. Management of sarcopenia requires addressing both skeletal muscle quantity and quality. Emerging evidence suggests that green tea catechins play an important role in maintaining healthy joints and skeletal muscle. This review covers (i) the prevalence and etiology of osteoarthritis and sarcopenia, such as excessive inflammation and oxidative stress, mitochondrial dysfunction, and reduced autophagy; (ii) the effects of green tea catechins on joint health by downregulating inflammatory signaling mediators, upregulating anabolic mediators, and modulating miRNAs expression, resulting in reduced chondrocyte death, collagen degradation, and cartilage protection; (iii) the effects of green tea catechins on skeletal muscle health via maintaining a dynamic balance between protein synthesis and degradation and boosting the synthesis of mitochondrial energy metabolism, resulting in favorable muscle homeostasis and mitigation of muscle atrophy with aging; and (iv) the current study limitations and future research directions.
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22
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Ogisu K, Masuda A, Fujita T, Yamazaki Y, Kobayashi M, Terao S, Sanuki T, Okada A, Adachi M, Arisaka Y, Miyazaki H, Yoshinaka H, Kutsumi H, Umegaki E, Kodama Y. Influence of sex on the association between body mass index and frequency of upper gastrointestinal symptoms. JGH OPEN 2020; 4:937-944. [PMID: 33102767 PMCID: PMC7578286 DOI: 10.1002/jgh3.12368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 12/17/2022]
Abstract
Background and Aim Upper gastrointestinal symptoms (UGSs), including reflux and dyspeptic symptoms (postprandial distress syndrome [PDS] and epigastric pain syndrome [EPS]), affect health‐related quality of life. However, the influence of sex on the relationship between body mass index (BMI) and UGSs remains controversial. This study investigates the influence of sex on this association in healthy subjects. Methods and Results We utilized the database of a prospective, multicenter, cohort study of 7112 subjects who underwent upper endoscopy for health screening. A multivariable logistic regression analysis was conducted to assess the association between BMI and UGSs stratified by sex, adjusting for clinical features. The influence of sex on the association between the overlapping of UGSs and BMI in symptomatic subjects was also investigated. Reflux symptoms were significantly associated with high BMI (multivariable odds ratio [OR] 1.36; 95% confidence interval [CI] 1.10–1.67, P = 0.004). PDS symptoms were significantly associated with low BMI (OR 2.37; 95% CI 1.70–3.25; P < 0.0001), but EPS symptoms were not associated with BMI. The association between reflux symptoms and higher BMI was limited to men (men: OR 1.40; 95% CI 1.10–1.77; P = 0.005, women: P = 0.40). sex did not influence the association between the presence of PDS symptoms and lower BMI. The percentage of overlapping of all three symptoms (reflux, PDS, and EPS) was higher in women than in men (19.9% [58/292] vs 10.5% [49/468], P = 0.0002). Conclusions The influence of BMI on the presence of UGSs was significantly different according to sex in this large‐scale cohort.
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Affiliation(s)
- Kyohei Ogisu
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan.,Department of Gastroenterology Nissay Hospital Osaka Japan
| | - Atsuhiro Masuda
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Tsuyoshi Fujita
- Department of Health Care Yodogawa Christian Hospital Osaka Japan
| | - Yukinao Yamazaki
- Department of Gastroenterology Fukui Red Cross Hospital Fukui Japan
| | - Masao Kobayashi
- Department of Health Care Kyoto Second Red Cross Hospital Kyoto Japan
| | - Shuichi Terao
- Department of Gastroenterology Kakogawa Central City Hospital Kakogawa Japan
| | - Tsuyoshi Sanuki
- Department of Gastroenterology Kita-Harima Medical Center Ono Japan
| | - Akihiko Okada
- Department of Gastroenterology Saiseikai Nakatsu Hospital Osaka Japan
| | - Masayasu Adachi
- Department of Gastroenterology Hotel Okura Kobe Clinic Kobe Japan
| | - Yoshifumi Arisaka
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan.,Department of Gastroenterology Nissay Hospital Osaka Japan
| | - Haruka Miyazaki
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Hayato Yoshinaka
- Clinical Research and Medical Innovation Center Shiga University Medical Science Otsu Japan
| | - Hiromu Kutsumi
- Clinical Research and Medical Innovation Center Shiga University Medical Science Otsu Japan
| | - Eiji Umegaki
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan
| | - Yuzo Kodama
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan
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23
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Kurokawa R, Kanemitsu Y, Fukumitsu K, Takeda N, Yap JM, Suzuki M, Mori Y, Fukuda S, Uemura T, Tajiri T, Ohkubo H, Maeno K, Ito Y, Oguri T, Takemura M, Niimi A. The diagnostic utility of the frequency scale for the symptoms of gastroesophageal reflux disease questionnaire (FSSG) for patients with subacute/chronic cough. J Asthma 2020; 58:1502-1511. [PMID: 32746665 DOI: 10.1080/02770903.2020.1805750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The frequency scale for the symptoms of GERD (FSSG) questionnaire, which originally consists of acid-reflux and dysmotility symptom domains, is a succinct questionnaire to evaluate gastroesophageal reflux disease (GERD) symptoms. OBJECTIVES To evaluate the utility of subjective questionnaire of GERD for the diagnosis of GERD-related cough by using FSSG questionnaire. METHODS We recruited 256 patients with subacute/chronic cough between April 2012 and March 2018, who were analyzed using FSSG questionnaire and blood eosinophil counts. GERD-related cough was inferred through the presence of classic reflux symptoms including heartburn and/or typical coughing trigger (e.g. phonation, rising, lying, eating, and intake of certain food). The diagnosis was confirmed by response to specific treatments for GERD. Receiver operating characteristic curve analysis was performed to determine the cutoff score for the diagnosis. RESULTS One-hundred ten patients (43%) were diagnosed as having GERD-related cough. FSSG questionnaire was relevant for diagnosing GERD-related cough, with the area under the curve (AUC) of 0.70 (p < 0.0001, cutoff score 7 points, sensitivity 75%, specificity 62%). When limited to patients with blood eosinophils of ≤150/μL or those with sputum eosinophils of ≤3%, sensitivity and specificity of the diagnosis was increased, respectively (sensitivity and specificity; 79% and 65% for blood eosinophils and 82% and 68% for sputum eosinophils. p < 0.0001, AUC 0.74 for both). CONCLUSIONS The subjective questionnaire of GERD (FSSG) would be helpful in diagnosing GERD-related cough, particularly in patients with low blood or sputum eosinophil counts.
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Affiliation(s)
- Ryota Kurokawa
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Kensuke Fukumitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Norihisa Takeda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Jennifer Maries Yap
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Motohiko Suzuki
- Department of Neuro-otolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuta Mori
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Satoshi Fukuda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Takehiro Uemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Tomoko Tajiri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Ken Maeno
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Tetsuya Oguri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Masaya Takemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Aichi, Japan
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24
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Hoshino M, Omura N, Yano F, Tsuboi K, Yamamoto SR, Akimoto S, Masuda T, Kashiwagi H, Yanaga K. The evaluation of recumbent reflux by multichannel intraluminal impedance pH testing for patients with gastroesophageal reflux disease and sleep disturbance. Esophagus 2020; 17:348-354. [PMID: 31970574 DOI: 10.1007/s10388-020-00717-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/12/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM The relationship between gastroesophageal reflux disease (GERD) and sleep disturbance has recently been pointed out and is garnering substantial attention. Although there are reports that point out the effectiveness of medical treatment for sleep disturbance associated with GERD, examinations of the pathological condition, including reflux during sleep, are inadequate. In the present study, we evaluated the recumbent reflux in patients with GERD and sleep disturbance using multichannel intraluminal impedance pH (MII-pH), and attempted to suppress recumbent reflux by surgical treatment to examine the pathophysiology of patients with GERD and sleep disturbance. MATERIALS AND METHODS Of the 47 patients with GERD-related diseases in whom laparoscopic fundoplication was performed at The Jikei University Hospital from January 2016 to June 2017, 31 patients (average age: 55.9 ± 13.8 years, male in 25), excluding 9 with surgical indications only for esophageal hiatal hernia and 7 without postoperative evaluation, were the subjects of this study. All surgical procedures were performed by the Toupet method. We used the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep disturbance, setting 5.5 as the cut-off value, based on the report by Doi et al., with any conditions beyond this value deemed sleep disturbance. The evaluation of gastroesophageal reflux was carried based on the MII-pH using the Sleuth, manufactured by Sandhill Corporation, with an automatic analysis carried out by computer. Furthermore, recumbent abnormal reflux was defined as recumbent all reflux (times) > 7. All evaluations were performed preoperatively and at 3 months after the operation. The data were expressed in medians and interquartile ranges, with p < 0.05 defined as statistically significant by the Mann-Whitney, Wilcoxon, or Chi-squared test. RESULTS Although sleep disturbance was found in 19 cases (61%), 8 (42%) of which were actually confirmed as nighttime abnormal reflux, of whom 5 cases (63%) showed significant improvement in their sleep disturbance following the operation, with a PSQI score of lower than 5.5. Among these 5 cases, postoperative recumbent abnormal reflux was also significantly reduced as compared with the preoperative condition (17 vs. 2 times/day, p = 0.042). Furthermore, sleep disturbance improved and recumbent abnormal reflux also decreased in two cases, with sleep disturbance improved by controlling the nighttime reflux via surgery in a total of 7 cases (87.5%). Although the PSQI score was as high as 14 points before and after the operation in one case, the rate of recumbent abnormal reflux was remarkably reduced, with sleep disturbance and recumbent reflux considered irrelevant. Furthermore, regarding the frequency of recumbent acid/non-acid reflux, while non-acid reflux was significantly more frequent in the patients with recumbent reflux complications (9 vs. 1 time/day, p < 0.001), there was no marked difference in the frequency of acid reflux. CONCLUSIONS Among cases with GERD and sleep disturbance, approximately one-third of them showed findings suggestive of the involvement of recumbent reflux in sleep disturbance, with reflux characterized by non-acid reflux.
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Affiliation(s)
- Masato Hoshino
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Nobuo Omura
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Fumiaki Yano
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuto Tsuboi
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Se Ryung Yamamoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shunsuke Akimoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takahiro Masuda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hideyuki Kashiwagi
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan
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25
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Nirwan JS, Hasan SS, Babar ZUD, Conway BR, Ghori MU. Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis. Sci Rep 2020; 10:5814. [PMID: 32242117 PMCID: PMC7118109 DOI: 10.1038/s41598-020-62795-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/19/2020] [Indexed: 12/13/2022] Open
Abstract
Although gastro-oesophageal reflux disease (GORD) is a common medical complaint, there is currently no consensus on the global prevalence of GORD. The aim of this study was to conduct a systematic review and meta-analysis on GORD prevalence and risk factors at a global level. MEDLINE, EMBASE, CINAHL, Scopus, Cochrane library, and Google Scholar were systematically searched, without language restrictions, for studies on the prevalence and risk factors of GORD. Data were pooled using a random effects model (95% confidence interval), and the odds ratio and relative risk for each risk factor were calculated. Out of 34,355 search results, 96 records reporting the results from 102 studies fulfilled the inclusion criteria, representing 37 countries and all regions of the UN geoscheme. The global pooled prevalence of GORD was 13.98% and varied greatly according to region (12.88% in Latin America and the Caribbean to 19.55% in North America) and country (4.16% in China to 22.40% in Turkey). Using the United Nations 2017 Revision of World Population Prospects, the estimated number of individuals suffering from GORD globally is 1.03 billion. Multiple risk factors associated with a significant increase in the risk of GORD were also identified. This systematic review and meta-analysis revealed that although a substantial proportion (13.98%) of the global population suffers from GORD, there are significant variations between regions and countries. Risk factors for GORD were also identified which may allow clinicians to recognise individuals most at risk.
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Affiliation(s)
- Jorabar Singh Nirwan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK
| | - Muhammad Usman Ghori
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK.
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26
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Atta MM, Sayed MH, Zayed MA, Alsulami SA, Al-Maghrabi AT, Kelantan AY. Gastro-oesophageal reflux disease symptoms and associated risk factors among medical students, Saudi Arabia. Int J Gen Med 2019; 12:293-298. [PMID: 31692498 PMCID: PMC6707933 DOI: 10.2147/ijgm.s206995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/25/2019] [Indexed: 12/20/2022] Open
Abstract
Background and aims Gastro-oesophageal reflux disease (GERD) is a common gastrointestinal disease worldwide that is associated with impaired quality of life and higher risk of complications. The identification of risk factors is necessary for preventive measures. The aim of this study is to evaluate the prevalence of GERD symptoms as well as its relation to body mass index (BMI) and other risk factors among medical students of Jeddah and Rabigh branches, King Abdul-Aziz University, Saudi Arabia. Subjects and methods A cross-sectional study was conducted at the Faculty of Medicine in Rabigh, King Abdul-Aziz University, Saudi Arabia. The study included 197 medical students from Rabigh and Jeddah branches of the university. The study employed a Gastroesophageal Reflux Disease Questionnaire which is derived from a self-administered validated GERD questionnaire (GerdQ). Results The prevalence of GERD symptoms was 25.9%. The most frequent symptoms were regurgitation and burning sensation. High BMI, family history, energy drinks and fried food were found to be statistically significant risk factors (p<0.05) by univariate analysis. However, the logistic regression for the prediction of GERD symptoms among medical students showed that only family history had a significant correlation (p<0.05). Conclusion GERD symptoms were common in medical students of King Abdulaziz University, Saudi Arabia. Family history was found to be a significant predictor of GERD symptoms. Effective educational strategies for groups with significant risk factors of GERD need to be implemented.
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Affiliation(s)
- Mohamed Magdi Atta
- Department of Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Hisham Sayed
- Department of Pediatrics, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A Zayed
- Department of Physiology, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Physiology, Faculty of Medicine, Menoufia University, Shibīn Al Koum, Egypt
| | - Sultan A Alsulami
- Department of Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed T Al-Maghrabi
- Department of Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulhfeez Y Kelantan
- Department of Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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27
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Wang G, Qu C, Wang L, Liu H, Han H, Xu B, Zhou Y, Li B, Zhang Y, Sun Z, Gong J, Li L, Wu W. Utility of 24-hour pharyngeal pH monitoring and clinical feature in laryngopharyngeal reflux disease. Acta Otolaryngol 2019; 139:299-303. [PMID: 31056040 DOI: 10.1080/00016489.2019.1571280] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND pH monitoring can reflect the changes in H+ in the airway. OBJECTIVES To explore the utility of pharyngeal pH monitoring in the diagnosis of laryngopharyngeal reflux disease (LPRD). MATERIAL AND METHODS Clinical data from 956 suspected LPRD patients from February 2016 to March 2018 were analyzed retrospectively. RESULTS One hundred forty-one patients had positive Ryan score. The positive rates of reflux symptom index (RSI), reflux finding score (RFS), RSI and RFS and RSI or RFS were 14.7%, 32.5%, 21.9%, 7.8% and 46.5%, respectively. The RFS in the positive Ryan score group was higher than that in the negative Ryan score group [(6 ± 3.5) vs. (4.8 ± 2.9)], while the RSI was not significantly different from that in the negative Ryan score group [(10.9 ± 8) vs. (11.3 ± 7.1)]. Regarding Ryan score as the gold standard in the diagnosis of LPRD, the sensitivity, specificity, positive and negative predictive value of identifying LPRD by RSI/RFS were 15.9%, 86.3%, 50.4% and 54%, respectively. CONCLUSIONS Ryan score, RSI and RFS have poor correlation in detecting LPRD. Some patients may be missed with the Ryan score as a diagnostic criterion. SIGNIFICANCE Pharyngeal pH monitoring is useful and more appropriate index is expected.
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Affiliation(s)
- Gang Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Changmin Qu
- Department of Gastroenterology, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Lei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Hongdan Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Haolun Han
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Bingxin Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Ying Zhou
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Baowei Li
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Yiyan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Zhezhe Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Jing Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Lianyong Li
- Department of Gastroenterology, Chinese People Liberation Army 306th Hospital, Beijing, China
| | - Wei Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army 306th Hospital, Beijing, China
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Mano F, Ikeda K, Sato T, Nakayama T, Tanaka D, Joo E, Takahashi Y, Kosugi S, Sekine A, Tabara Y, Matsuda F, Inagaki N. Reduction in Gastroesophageal Reflux Disease Symptoms Is Associated with Miso Soup Intake in a Population-Based Cross-Sectional Study: The Nagahama Study. J Nutr Sci Vitaminol (Tokyo) 2019; 64:367-373. [PMID: 30381627 DOI: 10.3177/jnsv.64.367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dietary habits and lifestyles are considered to affect the frequency of epigastric symptoms. In our previous study, we found that three amino acids in Japanese broth promoted gastric emptying. We hypothesized that a higher consumption of miso soup which was mainly composed of Japanese broth and miso paste would be associated with a lower frequency of epigastric symptoms. We conducted a cross-sectional study of the association between frequency of miso soup intake and reflux or dyspepsia symptoms in a general Japanese population. Sixteen items of dietary habits were assessed using a self-reported questionnaire, and epigastric symptoms were evaluated using the Frequency Scale for Symptoms of Gastroesophageal Reflux Disease (FSSG). We fitted generalized linear models to analyze the association between miso soup intake and FSSG, reflux, or dyspepsia scores adjusted by age, sex, body mass index (BMI), another 15 dietary habits, smoking, drinking alcohol, and unfavorable dietary behaviors. A total of 9,364 subjects were included in the analysis. Trend analysis revealed that higher frequency of miso soup intake was associated with lower FSSG scores (p<0.001). In a generalized linear model, daily intake of miso soup was associated with lower FSSG, reflux, and dyspepsia scores independent of age, sex, BMI, other 15 dietary habits, smoking, drinking alcohol, and unfavorable dietary behaviors (estimate=-0.46, -0.22, and -0.27, respectively; 95% CI=-0.83, -0.12; -0.38, -0.07; and -0.47, and -0.08, respectively). Dairy intake of miso soup was associated with lower epigastric symptoms.
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Affiliation(s)
- Fumika Mano
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Tosiya Sato
- Department of Biostatistics, Kyoto University School of Public Health
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health
| | - Daisuke Tanaka
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Erina Joo
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | | | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health
| | | | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
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Wei TY, Hsueh PH, Wen SH, Chen CL, Wang CC. The role of tea and coffee in the development of gastroesophageal reflux disease. Tzu Chi Med J 2019; 31:169-176. [PMID: 31258293 PMCID: PMC6559035 DOI: 10.4103/tcmj.tcmj_48_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective The incidence of gastroesophageal reflux disease (GERD) is increasing, and the disease has a close association with dietary habits. This study aims to investigate the role of tea and coffee drinking in the development of GERD. Materials and Methods This study prospectively enrolled individuals who underwent an upper gastrointestinal endoscopy during a health checkup. Each participant completed the reflux disease questionnaire (RDQ). Coffee or tea drinking was defined as drinking the beverage at least 4 days/week for 3 months. Heavy coffee or tea consumption was defined as drinking at least two cups every day. Results A total of 1837 participants (970 men; age 51.57 ± 10.21 years), who had data on clinical characteristics and consumption of coffee and tea with or without additives such as milk or sugar were included for final analysis. Among them, 467 (25.4%) were diagnosed as having symptomatic GERD based on the RDQ score, and 427 (23.2%) had erosive esophagitis (EE) on endoscopy. Drinking coffee or tea was not associated with reflux symptoms or EE in univariate and multivariate analyses. In contrast, drinking coffee with milk was associated with reflux symptoms and drinking "tea and coffee" was associated with EE in univariate analysis. However, these associations became insignificant after multivariate analysis. Conclusion Drinking coffee or tea and adding milk or sugar was not associated with reflux symptoms or EE.
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Affiliation(s)
- Tao-Yang Wei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pang-Hsin Hsueh
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Shu-Hui Wen
- Department of Public Health, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chia-Chi Wang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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30
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Cao H, Huang X, Zhi X, Han C, Li L, Li Y. Association between tea consumption and gastroesophageal reflux disease: A meta-analysis. Medicine (Baltimore) 2019; 98:e14173. [PMID: 30681584 PMCID: PMC6358326 DOI: 10.1097/md.0000000000014173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is one of the most common digestive system diseases, which is associated with lifestyle and dietary factors. The main mechanism involved in GERD is affected by demographics, lifestyles, and dietary factors. Tea consumption is reported to be associated with GERD, especially in Asian population. However, the effect of tea drinking on GERD risk is still controversial. The aim of this study was to investigate the relationship between tea consumption and the risk of GERD by meta-analysis. METHODS We searched the published research databases such as PubMed and Embase for studies that were published up to March 2018. The search results were reviewed by 2 authors, and studies that complied with the criteria were selected. Odds ratio (OR) and 95% confidence interval (CI) were used to assess the association between tea consumption and the risk of GERD. RESULTS Twenty-three articles including 30 studies were included in the meta-analysis. The result of meta-analysis showed that tea drinking had no significant association with the risk of GERD. The odds ratio (OR) and 95% CI were 1.12 and (0.98-1.27). In subgroup analysis based on geographical region, tea consumption can increase the risk of GERD in East Asia (OR = 1.27, 95% CI = 1.07-1.51), while the risk of GERD was decreased in Middle Asia (OR = 0.77, 95% CI = 0.63-0.95). Besides, in the subgroup of study design, there was a significant association between tea intake and the GERD in cross-sectional study. In no symptom subgroup, the risk of GERD was increased (OR = 1.47, 95% CI = 1.11-1.93). CONCLUSIONS There was no significant relationship between tea consumption and the risk of GERD overall. However, in subgroup analysis, tea drinking may increase the risk of GERD in East Asia and decrease in Middle Asia. To clarify the causality between tea intake and GERD, a more precise study design will be needed.
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Affiliation(s)
- Hongying Cao
- Department of Pathology, Jining No.1 People's Hospital, Jining, Shandong
| | | | - Xiaosong Zhi
- Department of Cell Biology, Second Military Medical University, Shanghai
| | - Cuihong Han
- Department of Pathology, Jining No.1 People's Hospital, Jining, Shandong
| | - Liang Li
- Department of Pathology, Jining No.1 People's Hospital, Jining, Shandong
| | - Yuyi Li
- Department of Proctology, Jining No.1 People's Hospital, Jining, Shandong, China
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31
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Alrashed AA, Aljammaz KI, Pathan A, Mandili AA, Almatrafi SA, Almotire MH, Bahkali SM. Prevalence and risk factors of gastroesophageal reflux disease among Shaqra University students, Saudi Arabia. J Family Med Prim Care 2019; 8:462-467. [PMID: 30984655 PMCID: PMC6436310 DOI: 10.4103/jfmpc.jfmpc_443_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction Gastroesophageal reflux disease (GERD) is one of the most common chronic gastrointestinal disorders in adults, it develops when the stomach contents reflux and rise up into the esophagus as a result from lower esophageal sphincter dysfunction. Stomach acid that touches the lining of the esophagus causes symptoms and complications. The classical symptoms of GERD include heartburn, usually after eating, chest pain, and regurgitation. Aim To measure the prevalence of gastroesophageal reflux disease and determine its risk factors among the students of Shaqra University. Methods A cross-sectional study was conducted using a structured questionnaire distributed among Shaqra University students after multistage stratification and random sampling technique to stratify students according to gender and the three main colleges in Shaqra city, Saudi Arabia. The sample size was determined to be 435 with the precision of ± 5% and a 95% confidence interval (CI). The questionnaire included demographic data like age, gender, height and weight, lifestyle, and dietary habits. Statistical data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16. Results with a P value of <0.05 were considered statistically significant. Results A total of 400 [227 (56%) male and 173 (43%) female] participants were evaluated. And 95 participants got a gastroesophageal reflux disease questionnaire score of ≥8 thus determining the prevalence of GERD to be 23.8%. Univariate analysis revealed that gender, smoking, familial history of GERD, high body mass index (>25 kg/m2), fast food, tea, carbonated beverages consumption, quick eating, and sleeping within 1 hour of dinner are associated with symptomatic GERD (P < 0.05). Conclusion The results show a high prevalence of GERD in Shaqra university students and the presence of many modifiable risk factors which merits the conduction of public health campaigns to raise awareness about the disease and its risk factors.
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Affiliation(s)
| | | | - Aslam Pathan
- Department of Pharmacology and Therapeutics, College of Medicine, Sahqra University, Shaqra, Saudi Arabia
| | - Aeshah A Mandili
- College of Medicine, Umm Al-qura University, Makkah, Saudi Arabia
| | - Samah A Almatrafi
- College of Medicine, King Saud bin Abdulaziz for Health Sciences, Jeddah, Saudi Arabia
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32
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Kim JJ. Epidemiology of Gastroesophageal Junction Adenocarcinoma in Korea. J Gastric Cancer 2018; 18:328-338. [PMID: 30607296 PMCID: PMC6310763 DOI: 10.5230/jgc.2018.18.e38] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 12/20/2022] Open
Abstract
The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low Helicobacter pylori (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Although similar trends in the prevalence of GERD, obesity, and HP infection are observed in Asian countries after a time lag from Western countries, it is still uncertain if the prevalence of GEJAC in Asian countries is increasing, especially in Korea. The incidence of GERD in Korea is currently increasing; it was below 3% in the 1990s. The incidence of obesity in the Korean population is increasing owing to the adoption of westernized lifestyles, including food preferences, and the HP infection rate in Korea is known to be decreasing. Therefore, based on logical extrapolation of observations of Western countries, the incidence of GEJAC will increase in Korea. However, the proportion of GEJAC among other upper gastrointestinal malignancies in Korea appears to be currently unchanged compared with that in the 1990s. Presently, there is a lack of epidemiologic studies on this issue in this region; therefore, more studies are needed to clarify the characteristics of these tumors and to improve clinical outcomes for patients with these tumors.
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Affiliation(s)
- Jin-Jo Kim
- Division of Gastrointestinal Surgery, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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33
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Eslami O, Shahraki M, Bahari A, Shahraki T. Dietary habits and obesity indices in patients with gastro-esophageal reflux disease: a comparative cross-sectional study. BMC Gastroenterol 2017; 17:132. [PMID: 29179692 PMCID: PMC5704630 DOI: 10.1186/s12876-017-0699-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/20/2017] [Indexed: 12/15/2022] Open
Abstract
Background Gastro-esophageal reflux disease (GERD) is suggested to be associated with some socio-demographic and lifestyle factors. Although the roles of some factors such as obesity are well documented, evidence on the impact of other factors such as dietary habits are still inconclusive. The aim of this study was to determine the relationship between socio-demographic and lifestyle factors with GERD in participants referred to a teaching hospital in Zahedan, South-East of Iran. Methods This comparative cross-sectional study was conducted during 2014–2015. All patients completed a structured questionnaire regarding information on socio-demographic status, lifestyle factors and dietary habits. Anthropometric indices including body mass index (BMI) and waist circumference (WC) were used to determine general and central obesity, respectively. Data were analyzed using SPSS software version 22. Value of p < 0.05 was considered as statistically significant. Results Five hundred and five participants, including 285 GERD and 220 Non-GERD participants participated in the study. In univariate analysis, being married (OR = 1.57, 95%CI = 1.04, 2.36), general obesity (OR = 1.77, 95%CI = 1.11, 2.81), central obesity (OR = 2.09, 95%CI = 1.46,3.01) and consumption of citrus fruits between meals (OR = 1.69, 95%CI = 1.04, 2.73) were associated with higher odds of GERD, while higher educational level (OR = 0.53, 95%CI = 0.36,0.77) and regular physical activity ≥2 h/week (OR = 0.53, 95%CI = 0.30, 0.94) were associated with lower odds of GERD. In the adjusted model, central obesity (OR = 1.88, 95%CI = 1.18, 3.01) and consumption of citrus fruits between meals (OR = 2.22, 95%CI = 1.30, 3.81) were positively associated with odds of GERD, while higher educational level (OR = 0.55, 95%CI = 0.33, 0.91) was associated with decreased odds of GERD. Conclusion According to the results of the current study, central obesity as determined by WC and citrus fruit intake were independent factors associated with GERD. Therefore, lifestyle modification might have a positive effect in the treatment of GERD in an urban population of Iran. Electronic supplementary material The online version of this article (10.1186/s12876-017-0699-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Omid Eslami
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mansour Shahraki
- Department of Nutrition, Faculty of Medicine & Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, P.O. Box :98167-4315, Zahedan, Iran.
| | - Ali Bahari
- Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Touran Shahraki
- Department of Pediatrics, Faculty of Medicine & Children and Adolescents Health Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
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Alkhathami AM, Alzahrani AA, Alzhrani MA, Alsuwat OB, Mahfouz MEM. Risk Factors for Gastroesophageal Reflux Disease in Saudi Arabia. Gastroenterology Res 2017; 10:294-300. [PMID: 29118870 PMCID: PMC5667695 DOI: 10.14740/gr906w] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/25/2017] [Indexed: 12/12/2022] Open
Abstract
Background Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal tract diseases worldwide. GERD has an effect on the patients' quality of life as well as the health care system that can be prevented by identifying its risk factors among the population. Hence, we applied this study to assess the GERD's risk factors in Saudi Arabia. Methods A cross-sectional study was designed to assess the GERD's risk factors among the community of Saudi Arabia. The sample was collected randomly during the period from November to December 2016. Through a self-administered validated GERD questionnaire (GerdQ), GERD was diagnosed. Then, the GERD's risk factors were assessed among all participants. The data were analyzed using Statistical Package for Social Sciences version 21.0; the Student's t-test was used to assess the association of GERD and risk factors. Results A total of 2,043 subjects participated in the study. The characteristics and behaviors of participants statistically significant with GERD were positive family history (39.3%), obese (body mass index > 30 kg/m2) (39.4%), not performing weekly regular physical activities ≥ 30 min (31.1%) and smoking (39.3%). GERD was commonly noticed in participants on analgesics (38.4%), not taking fibers (37.4%), drinking tea (33.4%), eating greasy (31.2%) and fast food (32.7%), and these were statistically significant with GERD (P ≤ 0.05). Conclusion The characteristics and behaviors associated with GERD in Saudi population are family history of GERD, obesity, sedentary lifestyle and smoking. Other common risk factors correlated with GERD are analgesics intake, no fibers intake, drinking tea, greasy and fast food intake.
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Affiliation(s)
| | | | | | | | - Mohammad Eid Mahmoud Mahfouz
- College of Medicine, Taif University, Taif, Saudi Arabia.,King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia
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Yang A, Kang B, Choe JY, Kim HS, Kim K, Choe YH. Prevalence and Epidemiological Characteristics of Endoscopically Proven Reflux Esophagitis in Children in Korea. Pediatr Gastroenterol Hepatol Nutr 2017; 20:160-166. [PMID: 29026732 PMCID: PMC5636932 DOI: 10.5223/pghn.2017.20.3.160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/03/2017] [Accepted: 05/26/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The prevalence of reflux esophagitis (RE) has increased recently in Korea. Little is known concerning the prevalence and characteristics of RE in pediatric patients. This study investigated the prevalence and influence of risk factors in endoscopically proven RE in Korea in pediatric patients over a period of 14 years. METHODS A retrospective chart review of all patients between the ages of 1 month and 20 years who underwent esophagogastroduodenoscopy at Samsung Medical Center between 2001 and 2014 was carried out. Univariate and multivariate analyses were conducted to identify independent risk factors for RE. RESULTS The prevalence rate of endoscopically proven RE in this study was 28.7% (978/3,413). The prevalence of RE increased from 11.8% from 2001 to 2007 to 37.7% from 2008 to 2014. Multivariate logistic regression analysis revealed that residency in the Greater Gangnam area (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.44) and age (OR, 1.13; 95% CI, 1.11-1.15) were significant predictive factors for the presence of RE. CONCLUSION The prevalence rate of endoscopically proven pediatric RE has increased over the past 14 years. Residency and older age are more important independent risk factors for pediatric RE in Korea.
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Affiliation(s)
- Aram Yang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ben Kang
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Young Choe
- Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hye Seung Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yon Ho Choe
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chang CH, Wu CP, Wang JD, Lee SW, Chang CS, Yeh HZ, Ko CW, Lien HC. Alcohol and tea consumption are associated with asymptomatic erosive esophagitis in Taiwanese men. PLoS One 2017; 12:e0173230. [PMID: 28264069 PMCID: PMC5338804 DOI: 10.1371/journal.pone.0173230] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/18/2017] [Indexed: 12/13/2022] Open
Abstract
Objective Asymptomatic erosive esophagitis (AEE) is commonly found in men, and might be a risk factor of developing esophageal adenocarcinoma. We aimed to determine if specific dietary habits increase the risk of AEE in asymptomatic Taiwanese men. Methods We recruited male adults undergoing upper gastrointestinal endoscopy for health check. We excluded subjects with reflux symptoms, or taking anti-reflux medications or drugs that potentially impair lower esophageal sphincter function or cause mucosal injury. The frequency of consuming reflux-provoking diets including alcohol, tea, coffee, tomato/citric juice, chocolate, sweet food, and spicy food was assessed. The erosive esophagitis was diagnosed based on the Los Angeles Classification after endoscopy. Frequent consumption of a specific diet was defined as ≥4 days/week of consuming that diet. Results A total of 1256 participants were recruited. After excluding 424 ineligible subjects, AEE was identified in 180 (22%) among 832 asymptomatic subjects. The risk of AEE increased with the number of days per week of consuming alcohol or tea: nondrinkers (19%, 17%), occasional drinkers (<1 day/week; 19%, 15%), regular drinkers (1–3 days/week; 26%, 21%), frequent drinkers (4–6 days/week; 32%, 22%), and daily drinkers (42%, 28%), respectively (trend test P < 0.001 for both). Multivariate analysis showed that hiatus hernia (adjusted odds ratio (aOR) 5.0, 95% confidence interval (CI) 2.6–9.6), drinking alcohol ≥4 days/week (aOR 2.3, 95% CI 1.3–4.0), and drinking tea ≥4 days/week (aOR 1.6, 95% CI 1.1–2.3) are independent risk factors of AEE. The risk of AEE was 3.8 times greater for those drinking both alcohol and tea ≥4 days/week than the non-drinkers. Conclusions Frequent alcohol and tea consumption increased the risk of AEE in Taiwanese men.
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Affiliation(s)
- Chung-Hsin Chang
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Pin Wu
- Health Examination Center, China Medical University Hospital, Taichung, Taiwan
- Preventive Medicine Center, China Medical University Hospital, Taichung, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shou-Wu Lee
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chi-Sen Chang
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Internal Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hong-Zen Yeh
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Wang Ko
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Han-Chung Lien
- Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Internal Medicine, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Okuyama M, Takaishi O, Nakahara K, Iwakura N, Hasegawa T, Oyama M, Inoue A, Ishizu H, Satoh H, Fujiwara Y. Associations among gastroesophageal reflux disease, psychological stress, and sleep disturbances in Japanese adults. Scand J Gastroenterol 2017; 52:44-49. [PMID: 27571846 DOI: 10.1080/00365521.2016.1224383] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population. METHODS A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS). GERD was divided into asymptomatic erosive reflux disease (a-ERD), symptomatic ERD (s-ERD), and non-erosive reflux disease (NERD), according to the presence or absence of esophageal mucosal injury on endoscopy, and the FSSG scores. Sleep disturbances were diagnosed in subjects with AIS score ≥6. RESULTS Prevalence of sleep disturbances was significantly higher in GERD subjects than in controls (35.9 and 14.7%, respectively), especially, in the NERD group (45.1%). Sleep duration was significantly shorter in the s-ERD group compared with other groups. Subjects in the NERD and s-ERD groups showed higher HADS scores, resulting in higher incidences of anxiety and depression than those in the control and a-ERD groups. Reflux symptoms, anxiety, depression, and coexisting functional dyspepsia, but not the presence of esophageal mucosal injury, were associated with an increased odds ratio for sleep disturbances. CONCLUSION There were significant positive associations among reflux symptoms, psychological stress, and sleep disturbance in Japanese adults. Further studies investigating the efficacy of therapy are needed.
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Affiliation(s)
- Masatsugu Okuyama
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Osamu Takaishi
- b Department of Gastroenterology , Naniwa Ikuno Hospital , Osaka , Japan
| | - Kenichi Nakahara
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Narika Iwakura
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Tomoki Hasegawa
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Maizumi Oyama
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Ayumi Inoue
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Hirotaka Ishizu
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Hiroshi Satoh
- a Department of Gastroenterology , Kashiwara Municipal Hospital , Kashiwara , Japan
| | - Yasuhiro Fujiwara
- c Department of Gastroenterology , Osaka City University Graduate School of Medicine , Osaka , Japan
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Wei JJ, Tang DP, Xie JJ, Yang LY, Zhuang ZH. Decreased n-6/n-3 polyunsaturated fatty acid ratio reduces chronic reflux esophagitis in rats. Prostaglandins Leukot Essent Fatty Acids 2016; 112:37-43. [PMID: 27637339 DOI: 10.1016/j.plefa.2016.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/27/2016] [Accepted: 08/15/2016] [Indexed: 12/12/2022]
Abstract
AIM To investigate the effect of dietary ratio of n-6/n-3 PUFAs on chronic reflux esophagitis (RE) and lipid peroxidation. METHOD Rat RE model were established and then fed on a diet contained different n-6/n-3 PUFA ratios (1:1.5, 5:1, 10:1) or received pure n-6 PUFA diet for 14 days. Esophageal pathological changes were evaluated using macroscopic examination and hematoxyline-eosin staining. IL-1β, IL-8, and TNFα mRNA and protein levels of were determined using RT-PCR and Western blotting, respectively. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined using ELISA. RESULTS The severity of esophagitis was lowest in the PUFA(1:1.5) group (P<0.05). IL-1β, IL-8, and TNFα mRNA and protein and MDA levels were significantly increased in model groups with the increasing n-6/n-3 PUFA ratios. SOD levels were significantly decreased in all RE PUFA groups (P<0.05). CONCLUSION Esophageal injury and lipid peroxidation appeared to be ameliorated by increased n-3 PUFAs intake.
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Affiliation(s)
- Jing-Jing Wei
- Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, China.
| | - Du-Peng Tang
- Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, China.
| | - Jing-Jing Xie
- Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, China.
| | - Li-Yong Yang
- Department of Endocrinology, the First Affiliated Hospital of Fujian Medical University, China.
| | - Ze-Hao Zhuang
- Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, China.
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Iwakiri K, Kinoshita Y, Habu Y, Oshima T, Manabe N, Fujiwara Y, Nagahara A, Kawamura O, Iwakiri R, Ozawa S, Ashida K, Ohara S, Kashiwagi H, Adachi K, Higuchi K, Miwa H, Fujimoto K, Kusano M, Hoshihara Y, Kawano T, Haruma K, Hongo M, Sugano K, Watanabe M, Shimosegawa T. Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015. J Gastroenterol 2016; 51:751-67. [PMID: 27325300 DOI: 10.1007/s00535-016-1227-8] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 02/04/2023]
Abstract
As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedance-pH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.
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Affiliation(s)
- Katsuhiko Iwakiri
- Department of Gastroenterology, Nippon Medical School Graduate School of Medicine, Sendagi 1-1-5, Bunkyo-ku, Tokyo, 113-8603, Japan. .,Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan.
| | - Yoshikazu Kinoshita
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Yasuki Habu
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Tadayuki Oshima
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Noriaki Manabe
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Yasuhiro Fujiwara
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Akihito Nagahara
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Osamu Kawamura
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Ryuichi Iwakiri
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Soji Ozawa
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Kiyoshi Ashida
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Shuichi Ohara
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Hideyuki Kashiwagi
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Kyoichi Adachi
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Kazuhide Higuchi
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Hiroto Miwa
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Kazuma Fujimoto
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Motoyasu Kusano
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Yoshio Hoshihara
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Tatsuyuki Kawano
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Ken Haruma
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Michio Hongo
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Kentaro Sugano
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Mamoru Watanabe
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
| | - Tooru Shimosegawa
- Guidelines Committee for Creating and Evaluating the "Evidence-based Clinical Practice Guidelines for Gastroesophageal Reflux Disease", the Japanese Society of Gastroenterology (JSGE), K-18 Building 8F, 8-9-13, Ginza, Chuo, Tokyo, 104-0061, Japan
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Mahdavinia M, Bishehsari F, Hayat W, Codispoti CD, Sarrafi S, Husain I, Mehta A, Benhammuda M, Tobin MC, Bandi S, LoSavio PS, Jeffe JS, Palmisano EL, Schleimer RP, Batra PS. Prevalence of allergic rhinitis and asthma in patients with chronic rhinosinusitis and gastroesophageal reflux disease. Ann Allergy Asthma Immunol 2016; 117:158-162.e1. [PMID: 27283453 DOI: 10.1016/j.anai.2016.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/12/2016] [Accepted: 05/19/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND An association between chronic rhinosinusitis (CRS) and gastroesophageal reflux disease (GERD) has been previously reported; however, the underlying factors linking CRS and GERD remain to be elucidated. OBJECTIVE To assess the association of GERD and CRS using prospective and retrospective approaches. METHODS The retrospective study comprised a large cohort of CRS cases, whereas the prospective arm evaluated a series of CRS cases and controls. RESULTS In the retrospective arm of the study, of the 1066 patients with CRS, 112 (10.5%) had GERD. Among patients with CRS, GERD was associated with higher body mass index, older age, and female sex. The odds ratios (ORs) for asthma and allergic rhinitis in the CRS group with GERD compared with the CRS group without GERD were 2.89 (95% confidence interval [CI], 1.905-4.389) and 2.021 (95% CI, 1.035-3.947). Furthermore, GERD was associated with a greater duration of CRS. Ninety patients with CRS and 81 controls were enrolled in the prospective arm of the study. In the CRS group, GERD was associated with asthma (OR, 4.77; 95% CI, 1.27-18.01). Patients with CRS and GERD had a longer duration and a younger age at onset of CRS. In controls, no association was found between GERD and asthma (OR, 0.67; 95% CI, 0.09-5.19) or allergic rhinitis (OR, 0.35; 95% CI, 0.05-2.59). CONCLUSION Patients with CRS and GERD are more likely to have atopic conditions and asthma when compared with patients with CRS but without GERD. One of the potential explanations of this link is that comorbid GERD and atopic disease are potential risk factors for development of CRS.
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Affiliation(s)
- Mahboobeh Mahdavinia
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois.
| | - Faraz Bishehsari
- Division of Gastroenterology, Internal Medicine Department, Rush University Medical Center, Chicago, Illinois
| | - Waqas Hayat
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Christopher D Codispoti
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Shahram Sarrafi
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Inna Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Arpita Mehta
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Mohamed Benhammuda
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Mary C Tobin
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Sindhura Bandi
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Philip S LoSavio
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Jill S Jeffe
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
| | - Erica L Palmisano
- Department of Immunology and Microbiology, Allergy/Immunology Section, Rush University Medical Center, Chicago, Illinois
| | - Robert P Schleimer
- Division of Allergy-Immunology, Internal Medicine Department, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
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Zia JK, Heitkemper MM. Upper Gastrointestinal Tract Motility Disorders in Women, Gastroparesis, and Gastroesophageal Reflux Disease. Gastroenterol Clin North Am 2016; 45:239-51. [PMID: 27261896 DOI: 10.1016/j.gtc.2016.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article reviews the sex differences in upper gastrointestinal (GI) motility for both healthy and common dysmotility conditions. It focuses on gastroesophageal reflux disease and other esophageal motor disorders for the esophagus and on gastroparesis and accelerated gastric emptying for the stomach. It also describes differences in upper GI motility signs and symptoms during each female hormonal stage (ie, menstrual cycle, pregnancy, perimenopause, menopause) for both healthy participants and those suffering from one of the aforementioned upper GI dysmotility conditions. More research still needs to be conducted to better understand sex differences in upper GI motility.
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Affiliation(s)
- Jasmine K Zia
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356424, Seattle, WA 98195-6424, USA.
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Systems, University of Washington, 1959 Northeast Pacific Street, Box 357266, Seattle, WA 98195-7266, USA
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42
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Affiliation(s)
- Seiji Futagami
- Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School, Japan
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43
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Kang JHE, Kang JY. Lifestyle measures in the management of gastro-oesophageal reflux disease: clinical and pathophysiological considerations. Ther Adv Chronic Dis 2015; 6:51-64. [PMID: 25729556 DOI: 10.1177/2040622315569501] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. These equivocal findings are partly due to methodology problems. There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint.
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Affiliation(s)
- J H-E Kang
- Green Templeton College, University of Oxford, Oxford, UK
| | - J Y Kang
- Department of Gastroenterology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK
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Tomita T, Yasuda T, Oka H, Terao S, Arai E, Oshima T, Fukui H, Hori K, Watari J, Miwa H. Atypical symptoms and health-related quality of life of patients with asymptomatic reflux esophagitis. J Gastroenterol Hepatol 2015; 30 Suppl 1:19-24. [PMID: 25827799 DOI: 10.1111/jgh.12745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Asymptomatic reflux esophagitis (RE) is simply regarded as RE without the typical reflux symptoms, but it is unknown whether patients with asymptomatic RE have atypical symptoms. The aim of this study was to examine the clinical characteristics and health-related quality of life (HRQOL) of patients with asymptomatic RE. PATIENTS AND METHODS Consecutive patients with RE were enrolled during January 2010 to August 2012, and of them, 41 who had taken acid-suppressing drugs were excluded, leaving 280 patients as the study group. The patients' symptoms were evaluated using a self-completed questionnaire (modified Frequency Scale for the Symptoms of gastroesophageal reflux disease [FSSG]), as well as an HRQOL questionnaire (SF-8). We defined the typical symptoms of RE as heartburn and regurgitation. Asymptomatic RE was defined if the total symptom score was 0 or the minimum (1 point) for typical reflux symptoms in the modified FSSG. RESULTS Of the 280 RE patients, 71.8% (n = 201) were symptomatic and 28.2% (n = 79) were asymptomatic. The atypical symptom scores were significantly lower in asymptomatic RE (2.2 ± 2.2) than in symptomatic RE patients (6.9 ± 5.2) (P < 0.0001), and the HRQOL scores were significantly higher in asymptomatic RE than in symptomatic RE (P < 0.0001). Sleep was significantly less disturbed and chronic cough less frequent in asymptomatic RE than in symptomatic RE. CONCLUSION Frequency and severity of atypical symptoms in patients with asymptomatic RE were significantly less than in patients with symptomatic RE, and the HRQOL score was significantly higher in those patients. These observations suggest a specific patient cohort that is truly unlikely to manifest symptoms.
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Affiliation(s)
- Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
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Hiramoto K, Fujiwara Y, Ochi M, Okuyama M, Tanigawa T, Yamagami H, Shiba M, Watanabe K, Watanabe T, Tominaga K, Arakawa T. Effects of esomeprazole on sleep in patients with gastroesophageal reflux disease as assessed on actigraphy. Intern Med 2015; 54:559-65. [PMID: 25786444 DOI: 10.2169/internalmedicine.54.3718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Although treatment with proton pump inhibitors (PPIs) helps to improve GERD symptoms and subjective sleep parameters, the effects of PPI therapy on objective sleep parameters are conflicting. The aim of this study was to examine the effects of esomeprazole treatment on GERD symptoms and sleep parameters assessed using actigraphs and questionnaires. METHODS Thirteen patients with GERD received 20 mg of esomeprazole once daily for two weeks. The patients wore actigraphs from three days before the initiation of PPI treatment to the end of therapy. They were also asked to answer the following self-reported questionnaires: Frequency Scale for the Symptoms of GERD (FSSG), Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep parameters were evaluated using actigraphy. RESULTS Treatment with esomeprazole significantly decreased the total FSSG score, including the scores for reflux and dysmotility, as well as the ESS score, although it had no effect on the PSQI score. After the second week of treatment, esomeprazole significantly decreased the wake time (from 47.5±39.6 min to 36.0±27.1 min) and sleep latency period (from 19.5±19.8 min to 9.9±10.2 min) and increased the percentage of sleep time (from 89.1±8.8% to 91.9±6.3%); however, improvements were not noted in all objective parameters. CONCLUSION Esomeprazole treatment significantly improves various objective sleep parameters in Japanese patients with GERD. Further placebo-controlled randomized trials are needed to obtain detailed results.
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Affiliation(s)
- Keiko Hiramoto
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan
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Haruma K, Kinoshita Y, Sakamoto S, Sanada K, Hiroi S, Miwa H. Lifestyle factors and efficacy of lifestyle interventions in gastroesophageal reflux disease patients with functional dyspepsia: primary care perspectives from the LEGEND study. Intern Med 2015; 54:695-701. [PMID: 25832928 DOI: 10.2169/internalmedicine.54.3056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Although gastroesophageal reflux disease (GERD), a very common disorder worldwide, is considered to be a lifestyle disease, the pathogenic role of lifestyle factors and consequently the efficacy of lifestyle interventions, remains controversial. Lifestyle factors associated with GERD and the beneficial effect of specific recommended lifestyle interventions in the primary care setting were evaluated as a post-hoc analysis of the LEGEND study which investigated the effect of lansoprazole in patients with GERD who reported dyspeptic symptoms. METHODS GERD patients with dyspepsia were treated with lansoprazole 15 mg or 30 mg daily for four weeks. Reflux and dyspeptic symptoms were evaluated using patient-reported questionnaires before and four weeks after the administration of lansoprazole. RESULTS Among 12,653 patients, "feelings of continued stress" was the most common lifestyle factor (45.6% of patients), and >30% of the patients reported "eating sweet foods at least once every two to three days," "eating greasy foods at least once every two to three days" and "drinking coffee almost daily." Introducing lifestyle interventions had a significant effect on both reflux and dyspeptic symptoms. CONCLUSION Lifestyle interventions are thus considered to be important in GERD patients with dyspepsia who receive a proton pump inhibitor.
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Affiliation(s)
- Ken Haruma
- Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Japan
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Abstract
The incidence of oesophageal adenocarcinoma has increased dramatically in the developed world in the last half century. Over approximately the same period there has been an increase in the prevalence of obesity. Multiple epidemiological studies and meta-analyses have confirmed that obesity, especially abdominal, visceral obesity, is a risk factor for gastro-oesophageal reflux, Barrett's oesophagus and oesophageal adenocarcinoma. Although visceral obesity enhances gastro-oesophageal reflux, the available data also show that visceral obesity increases the risk of Barrett's oesophagus and adenocarcinoma via reflux-independent mechanisms. Several possible mechanisms could link obesity with the risk of oesophageal adenocarcinoma in addition to mechanical effects increasing reflux. These include reduced gastric Helicobacter pylori infection, altered intestinal microbiome, factors related to lifestyle, the metabolic syndrome and associated low-grade inflammation induced by obesity and the secretion of mediators by adipocytes which may directly influence the oesophageal epithelium. Of these adipocyte-derived mediators, increased leptin levels have been independently associated with progression to oesophageal adenocarcinoma and in laboratory studies leptin enhances malignant behaviours in cell lines. Adiponectin is also secreted by adipocytes and levels decline with obesity: decreased serum adiponectin levels are associated with malignant progression in Barrett's oesophagus and experimentally adiponectin exerts anticancer effects in Barrett's cell lines and inhibits growth factor signalling. At present there are no proven chemopreventative interventions that may reduce the incidence of obesity-associated oesophageal cancer: observational studies suggest that the combined use of a statin and aspirin or another cyclo-oxygenase inhibitor is associated with a significantly reduced cancer incidence in patients with Barrett's oesophagus.
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Affiliation(s)
- Elizabeth Long
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Ian L P Beales
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
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48
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Futagami S, Yamawaki H, Shimpuku M, Izumi N, Wakabayashi T, Kodaka Y, Nagoya H, Shindo T, Kawagoe T, Sakamoto C. Impact of coexisting irritable bowel syndrome and non-erosive reflux disease on postprandial abdominal fullness and sleep disorders in functional dyspepsia. J NIPPON MED SCH 2014; 80:362-70. [PMID: 24189354 DOI: 10.1272/jnms.80.362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. METHODS The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. RESULTS There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. CONCLUSION Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.
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Affiliation(s)
- Seiji Futagami
- Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School
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Islami F, Nasseri-Moghaddam S, Pourshams A, Poustchi H, Semnani S, Kamangar F, Etemadi A, Merat S, Khoshnia M, Dawsey SM, Pharoah PD, Brennan P, Abnet CC, Boffetta P, Malekzadeh R. Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- a cross-sectional analysis of 50,000 individuals. PLoS One 2014; 9:e89256. [PMID: 24586635 PMCID: PMC3931722 DOI: 10.1371/journal.pone.0089256] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/17/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time. METHODS We performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼ 50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn. RESULTS Approximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02-1.75) and opium use (OR 1.70, 95% CI 1.55-1.87) were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76-0.99). After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined). CONCLUSION GERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere.
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Affiliation(s)
- Farhad Islami
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Siavosh Nasseri-Moghaddam
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, United States of America
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Shahin Merat
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Paul D. Pharoah
- Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Transitional Epidemiology, Mount Sinai School of Medicine, New York, New York, United States of America
- International Prevention Research Institute, Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Kim J, Oh SW, Myung SK, Kwon H, Lee C, Yun JM, Lee HK. Association between coffee intake and gastroesophageal reflux disease: a meta-analysis. Dis Esophagus 2013; 27:311-7. [PMID: 23795898 DOI: 10.1111/dote.12099] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gastroesophageal reflux disease (GERD) is one of the most common diseases affecting patients worldwide, but its risk factors and causes are not clearly known. The aim of this study was to investigate the effect of coffee intake on GERD by a meta-analysis. We searched online published research databases such as PubMed, EMBASE, and Cochrane Library for studies that were published up to December 2012. These publications were reviewed by two independent authors, and studies that fulfilled the criteria were selected. Whenever there was a disagreement between the authors, a consensus was reached by discussion. Fifteen case-control studies were included in the final analysis. A meta-analysis showed that there was no significant association between coffee intake and GERD. The odds ratio was 1.06 (95% confidence interval, 0.94-1.19). In subgroup analyses in which the groups were subdivided based on the definition of GERD (diagnosed by endoscopy or by symptoms alone), only the endoscopy group showed a significantly higher odds ratio. In subgroup analyses in which the groups were subdivided based on the amount of coffee intake, quality of study, and assessment of exposure, there was no significant association between coffee intake and GERD.
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Affiliation(s)
- J Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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