Sickness absence due to gastroesophageal reflux diagnoses: a nationwide Swedish population-based study

Impact of Gastroesophageal Reflux Disease (GERD) Symptoms on the Lifestyle and Academic Performance of Medical Students at King Faisal University

Background A number of symptoms and complications are associated with gastroesophageal reflux disease (GERD), which originates when stomach contents are refluxed into the esophagus. GERD has been associated with quality of life (QoL) issues as well as health-related problems. However, the evidence of this correlation among medical students is still unproven. This study aims to assess GERD severity and symptoms among medical students and investigate the effects of GERD on academic performance and quality of life among Saudi Arabian medical students. Methods This is a cross-sectional study design based on questionnaires distributed among medical students at King Faisal University, Saudi Arabia: Reflux-Qual Short form (RQS) and Frequency Scale for the Symptoms of GERD (FSSG). Demographic data include gender, academic year, and Grade Point Average (GPA). The participants included 382 studentsrandomly selected as the sample size, with a precision of 5% and a 95% confidence interval (CI). Results Data were collected from 382 medical students of King Faisal University. A total of 382 participants (215 (56.3%) females and 167 (43.7%) males) were evaluated. Among 382 students,325 (85.1%) were negative for GERD, while 57 (14.9%) had symptoms of GERD. In this study, the most frequent symptoms were feeling full while eating meals (8.9%), feeling of heaviness after meals (6.5%), bloating of the stomach (3.7%), and burping (3.7%). The most affected life domains were life satisfaction (18.1%), enjoyment of food (8.4%), avoidance of large meals (6.3%), and worrying about digestive problems (5.8%). This study shows a significant relationship between GERD and GPA (P < 0.005) and a significant negative relationship between GERD and QoL (P < 0.001). Conclusions GERD significantly affects the quality of life for medical students, primarily those with high GPAs. More research is needed to determine the reason behind this.

Gastroesophageal Reflux and Sleep Disturbances: A Bidirectional Association in a Population-Based Cohort Study, The HUNT Study

STUDY OBJECTIVES

To investigate the potentially bidirectional association between gastroesophageal reflux symptoms (GERS) and sleep disturbances/ insomnia disorders.

METHODS

We assessed the incidence of new-onset of self-reported GERS, sleep disturbances, and insomnia disorders in a population-based longitudinal cohort study (HUNT), performed in Nord-Trøndelag County, Norway. Modified Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs), adjusted for sex, age, body mass index, tobacco smoking, educational level, anxiety, and depression.

RESULTS

The study cohort included the 25,844 participants of the HUNT study who responded to health questionnaires in both 1995-1997 and 2006-2009. New-onset GERS, sleep disturbances, and insomnia disorders was reported in 396 (2%), 2,598 (16%), and 497 (3%) participants, respectively. Persistent sleep disturbances were associated with new-onset GERS (RR: 2.70, 95% CI: 1.93-3.76), persistent insomnia disorders were associated with new-onset GERS (RR: 3.42; 95% CI: 1.83-6.39) and persistent GERS was associated with new-onset sleep disturbances (RR: 1.41; 95% CI: 1.14-1.75).

CONCLUSIONS

Sleep disturbances and GERS seem to be bidirectionally associated, and sleep disturbances seem to be a stronger risk factor for GERS than the reverse.

Chronic diseases are strongly associated with sickness absences in a sample of Italian public employees

OBJECTIVES

Data on the prevalence of chronic diseases and their relationship with sickness absence in the Italian public employees are rather scarce. Therefore, in the first place, we assessed the distribution of chronic diseases in the employees of the University of Ferrara. As a next step, we investigated the possible associations between each chronic disease and cumulative days of all-cause sickness absence, and finally we investigated the odds ratio of each single chronic disease on sickness absence.

MATERIAL AND METHODS

A total of 514 employees, 269 sick-listed and 245 not sick-listed in 2012, were studied. Demographical/clinical characteristics and chronic diseases were obtained from all study participants during medical surveillance procedures. Sickness absence days and job seniority data were obtained from the administrative office.

RESULTS

Gastrointestinal and psychiatric diseases were the most reported in the sick-listed sample (p = 0.01 and p = 0.02, respectively, compared to the not sick-listed). In the interquantile regression analysis, the sickness absence days were associated with psychiatric diseases (β = 65.1, 95% CI: 13.2-117.1, p = 0.01) and with the presence of 2 or more chronic diseases (β = 23.3, 95% CI: 4.5-42, p = 0.02). Furthermore, the logistic regression analysis showed that the odds of sickness absence were increased 2 fold by psychiatric diseases (OR = 2.2, 95% CI: 1.01-4.93, p = 0.04), and gastrointestinal diseases (OR = 1.9, 95% CI: 1.07-3.42, p = 0.02) and, to a lesser extent, by high body mass index (OR = 1.05, 95% CI: 1-1.11, p = 0.03). Conversely, female gender reduced by half the odds of sickness absence (OR = 0.5, 95% CI: 0.3-0.8, p = 0.04).

CONCLUSIONS

This study highlights the relevant association between chronic diseases and sickness absence in Italian public employees. Our findings indicate the importance of considering the health status when designing preventive interventions aimed at decreasing sickness absences in this population.

Prevalence of symptoms of gastroesopahgeal reflux in a cohort of Saudi Arabians: a study of 1265 subjects

BACKGROUND/AIMS

In this study, we aimed to determine the prevalence of gastroesophageal reflux disease (GERD) in the general population of the capital city of Riyadh and to assess its association with other factors including age, smoking, body mass index (BMI), asthma, as well as the presence of other co-morbid diseases.

MATERIALS AND METHODS

We used the Gastroesophageal Reflux Disease Questionnaire (GerdQ) for diagnosing GERD, based on a GerdQ score of 8 or more. Riyadh was divided into four quadrants, and from each area, a single shopping mall was chosen randomly to conduct our surveys. Data collected included age, sex, history of smoking, history of asthma or any other medical condition, dietary habits, monthly household income, history and frequency of heartburn, epigastric pain, regurgitation of food, nausea, sleep disturbance from heartburn, the use of common over-the-counter antacids for the control of their symptoms, and their height and weight.

RESULTS

Over a 4-week period from the 19 December 2012 to 17 January 2013, a total of 1265 individuals were included in the survey. The mean age was 29.97 ± 11.58 years. Females formed 67.81% of the respondents and 62.73% had one or more episodes of heartburn per week. Based on a cutoff GERDQ score of 8, the prevalence of GERD in the surveyed population was 45.4%. GERD was more prevalent in older individuals (mean age 31.9 vs. 30.0 years, P < 0.001) and in those with a higher BMI (27.29 vs. 26.31 kg/m 2 , P = 0.02). There was no difference between males (45.43%) and females (45.13%) (P = 0.92); there was a trend of a higher prevalence in smokers (51.63% vs. 44.41%), but it did not reach statistical significance (P = 0.09).

CONCLUSION

Symptoms suggestive of GERD as determined by the translated GerdQ are prevalent among this study population.

Gastroesophageal reflux in the 21st century

PURPOSE OF REVIEW

Gastroesophageal reflux (GER) remains a common, challenging problem for clinicians, with differentiation of normal development from disease a particular issue. This review updates clinicians on advances in diagnosis of GER, relationship to other problems, and current practice in management.

RECENT FINDINGS

Development and understanding of multichannel intraluminal impedance-pH monitoring has given insights into the relationship of GER to symptoms. Medical treatment has changed little. Avoidance of overmedicalizing normal development is the major issue for clinicians. Laparoscopic fundoplication is established as equivalent to open fundoplication. Newer endoscopic techniques have only limited use in children to date.

SUMMARY

Major changes in pediatric GER relate to understanding of physiology and relationship of GER to symptoms. The major challenge for clinicians involve differentiation of normal from abnormal GER, and applying the most relevant management.