The Determinants of the Quality of Life of Gastroesophageal Reflux Disease Patients Attending King Saud University Medical City

Relationship between Helicobacter pylori infection and gastroesophageal reflux disease

Introduction

Gastroesophageal reflux disease (GERD) is a common disease that negatively affects the quality of life, and its pathophysiology is multifactorial.

Aim

Our study aims to investigate the relationship between histological and topographic characteristics of Helicobacter pylori (H. pylori) gastritis and the symptoms, presence, and severity of oesophagitis in patients with reflux symptoms.

Material and methods

The symptoms, demographic data, and physical examination results of the patients admitted with gastrointestinal complaints were recorded and oesophagogastroduodenoscopies were performed. Biopsies were taken from the antrum and corpus.

Results

Of the 171 patients, 113 were in the reflux group and 58 were in the non-reflux group. 103 (60%) of the patients were female and 68 (40%) were male. The mean age was 40 ±14 years in the GERD group and 49 ±16 years in the non-reflux group. There were no statistically significant differences between both groups in terms of endoscopic results or the presence and degree of oesophagitis. The total H. pylori frequency was found to be 73%; 75% in the GERD group and 69% in the non-reflux group. There was no significant relationship between the presence and degree of reflux oesophagitis. Chronic inflammation and neutrophil activity were higher in the antrum and corpus in the H. pylori-positive group, and gland atrophy was detected more frequently in the antrum in the H. pylori-negative group.

Conclusions

The histological type of gastritis caused by H. pylori rather than the presence of H. pylori may be associated with GERD.

Efficacy of One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass for Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials

This study aimed to investigate the efficacy of one-anastomosis gastric bypass (OAGB) on gastroesophageal reflux disease (GERD) compared with Roux-en-Y gastric bypass (RYGB) in patients with obesity. Three databases (Medline, Cochrane Central, and Scopus) were searched for relevant articles published until August 12, 2024. A total of nine randomized controlled trials, including 643 patients, were selected. OAGB was statistically significantly associated with a higher risk of GERD than RYGB (OR = 3.14, 95% CI 1.23-8.03, p < 0.05). The odds for de novo GERD after OAGB are almost six times higher than after RYGB (OR = 5.65, 95% CI 1.53-20.82, p < 0.05). RYGB has a lower incidence of de novo GERD cases and is more effective than OAGB in reducing GERD.

Correlation of gastrointestinal symptom rating scale and frequency scale for the symptoms of gastroesophageal reflux disease with endoscopic findings

BACKGROUND

Gastroesophageal Reflux Disease (GERD) is caused by the reflux of gastric contents into the esophagus and has a 13% global prevalence that is increasing. GERD symptoms negatively impact physical, social, and emotional quality of life. The Frequency Scale for the Symptoms of GERD (FSSG) and the Gastrointestinal Symptom Rating Scale (GSRS) determine the efficacy of treatment but may not correlate with endoscopically estimated esophageal mucosal injury severity. We aimed to probe the correlation between FSSG, GSRS, and esophageal injury severity to evaluate whether these scores can predict GERD severity.

METHODS

A total of 2962 patients who underwent physical examinations, including upper gastrointestinal endoscopy, at the Kyoto Kuramaguchi Medical Center, Japan, were enrolled in this study. Upper gastrointestinal endoscopy was used to diagnose fundic mucosal atrophy, reflux esophagitis based on the Los Angeles (LA) classification, gastroesophageal flap value function (GEFV) based on Hill's classification, and Barrett's esophagus. Endoscopic diagnoses were examined for correlations with FSSG and GSRS scores.

RESULTS

In reflux esophagitis, FSSG and GSRS scores correlated with LA-B and LA-C endoscopic diagnosis but not with LA-M and LA-A endoscopic findings. Multiple regression analysis results were similar. FSSG scores reflected advanced fundic gland mucosal atrophy, while GSRS scores associated with high grade of GEFV.

CONCLUSIONS

This is the first report to examine the correlation between FSSG and GSRS scores and endoscopic findings in a relatively large patient population. Our findings suggest that these scores can diagnose the severity of reflux esophagitis.

Factors to Effective Clinical Experience, Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in Southeast Nigeria and Rural Development

Objective

To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria.

Methods

The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection.

Results

Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students' clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment.

Conclusion

The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

Prevalence of Gastroesophageal Reflux Disease and Its Impact on the Quality of Life Among Obese Individuals in Al-Baha Region, Saudi Arabia

Background Gastroesophageal reflux disease (GERD) is a global gastrointestinal disorder, and obesity is a particular risk factor. Symptoms of GERD, such as heartburn and acid reflux, are caused by abnormal relaxation in the lower esophagus, causing gastric acid reflux. Persistent symptoms can affect the patient's quality of life (QOL) and can cause complications, such as esophageal adenocarcinoma. Management of GERD includes lifestyle changes, antacids, and anti-reflux surgery. Even though GERD is a common disease, few research has been carried out on it in Saudi Arabia. Aim This study aimed to estimate the prevalence of GERD and its associated risk factors among obese individuals in the Al-Baha region population and the effect of GERD on their QOL. Methods A cross-sectional study included 314 obese participants from the Al-Baha region. A questionnaire was filled out to measure the prevalence of GERD, risk factors, and effects on the QOL of the participants. Data were analyzed by the IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). Descriptive statistics and the chi-squared test were applied. Logistic regression analysis was used to determine the factors associated with the incidence of GERD. A p-value of <0.05 was considered statistically significant. Results A total of 314 patients who met our inclusion criteria completed the survey; 42% of them were women, the mean age of all patients was 35.3 ± 12.9 years, and 38.2% of the patients were diagnosed with GERD. Epigastric pain and burning sensation were the most common symptoms (44.9%). Five out of six domains in the QOL questionnaire showed more effects among GERD participants than non-GERD participants, and the results were statistically significant (p = 0.001). Logistic regression analysis showed that men are 1.8 times more likely than women to be diagnosed with GERD, and smokers have 2.6 times the risk of being diagnosed with GERD than non-smokers. Conclusion The present study showed a high prevalence of GERD among obese patients in the Al-Baha region, negatively affecting their QOL. Major risk factors included gender, smoking, dyslipidemia, and hypertension. Public health programs to raise awareness of these risk factors and lifestyle habits are necessary to improve QOL and prevent complications.

Factors influencing the quality of life of GERD patients in the Aseer Region, Saudi Arabia

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by troublesome symptoms, including heartburn and acid regurgitation. GERD is associated with complications such as peptic stricture, Barrett's esophagus, and esophageal adenocarcinoma, and it negatively affects quality of life (QoL).

Aims

To assess the factors influencing the QoL of GERD patients in the Aseer region of Saudi Arabia.

Settings and Design

This descriptive cross-sectional study used self-administered questionnaires in a study population of patients aged ≥18 years from Aseer, Saudi Arabia, between January 15, 2023-February 15, 2023.

Materials and Methods

A previously validated GERD health-related QoL (GERD-HRQoL) questionnaire was used to assess the patients' sociodemographic data, GERD, and GERD-HRQoL.

Statistical Analysis Used

Descriptive analysis included describing the frequency distribution and percentage for study variables, including demographic data, GERD-related QoL symptoms, and QoL, which were graphed. Cross-tabulation presented the distribution of GERD-HRQoL scores by their personal data and other factors using the Pearson Chi-square and exact probability tests.

Results

Overall, 502 participants previously diagnosed with GERD completed the questionnaire. Participants' were aged 18-65 years (mean age of 31.5 ± 14.6 years), and 384 (76.5%) were male. The most frequent symptom affecting QoL was heartburn (85.9%), followed by postprandial heartburn (84.3%), heartburn while lying down (82.7%), bloating or gassy feelings (79.9%), and heartburn while standing up (77.3%).

Conclusions

Our study showed that patients with GERD had a poor QoL due to GERD-related symptoms, mainly heartburn. Younger age, male sex, and lower educational status were associated with lower GERD-HRQoL scores.

Quality of life and severity of symptoms among patients with various degrees of reflux esophagitis: a prospective study

Gastro-esophageal reflux disease (GERD) can cause erosive esophagitis (EE) and compromise the quality of life (QoL). We examined differences in symptom severity and QoL according to EE severity grade. A follow-up study was conducted among GERD patients at the Nazareth Hospital in Israel. Patients underwent a baseline gastroscopy in 2014-2020 during which the EE grade was determined using the Los Angeles classification. Follow-up telephone interviews were conducted during 2019-2020 with a mean time interval of 18.9 months (SD = 14.9) after the baseline gastroscopy to assess GERD symptoms using the Reflux disease questionnaire (RDQ) and QoL using the GERD QoL questionnaire. The patients were interviewed in their native language (Arabic or Hebrew). Overall, 149 (66.4% males) patients were included; 50 had EE grades C/D and 99 had grades A/B. The mean age at baseline and follow-up was 44.6 years (SD = 15.1) and 46.2 years (SD = 14.9), respectively. Cronbach's alpha was 0.928 and 0.855 for the RDQ and QoL questionnaires, respectively. Patients with EE C/D grades had more severe symptoms than patients with EE A/B grades (P = 0.05), especially in regurgitation scores (P = 0.03). Females had more severe symptoms (overall) than males (adjusted OR = 2.34; 95% CI 1.12-4.90). Patients with the more severe esophagitis EE C/D group (adjusted OR = 1.98; 95% CI 0.93-4.24) and those who used PPIs treatment (adjusted OR = 2.19; 95% CI 0.95-5.01) reported more severe GERD symptoms. The number of schooling years was significantly associated with better QoL score (beta coefficient 1.33, P = 0.005) but not EE grade or GERD symptoms. Follow-up endoscopy conducted among 22 patients with EE grades C/D showed that 13 (59.1%) of these patients had normal endoscopic findings, 6 patients (27.3%) had a grade A EE, 1 patient (4.5%) had grade B, and 2 (9.1%) remained with grade C EE. The Arabic and Hebrew versions of the RDQ and QoL questionnaires were highly reliable. GERD symptoms severity was more profound among patients with more severe esophagitis. No significant association between EE grade and QoL; this negative result might be due to the improvement in esophagitis endoscopic findings among patients with C/D grade.

Prevalence of Gastroesophageal Reflux Disease and Associated Risk Factors in the Eastern Region, Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by heartburn and acid regurgitation. A higher incidence is found in Arab countries. Untreated GERD has a negative impact on individuals that interfere with daily activities and impaired quality of life. This study aims to estimate the prevalence of GERD and associated risk factors in the Eastern region, Saudi Arabia.

Material & Methodology

A descriptive cross-sectional study was carried out among 1517 healthy participants from the Eastern province of Saudi Arabia from May to August 2021. The sample was randomly collected through a structured self-administered questionnaire. The questionnaire was composed of questions related to sociodemographic and lifestyle characteristics as risk factors for GERD. The existence of GERD was assessed by using GERD Questionnaire (GerdQ) for diagnosing GERD, when the score is 8 or more.

Results

A total of 1517 participants were included in the study: 58.8% male, 41.2% female; 9% of whom were pregnant. The age of participants ranged from 18 to 58 with a mean age of 27.5 ± 11.4 years old. The existence of GERD was 20.6% among the total participants, in which their GerdQ scores were 3-7 (68.9%), 8-10 (22.1%), and 8-11 (8.5%). The higher risk groups of having GERD were pregnant women, smoker, being male, regular usage of analgesia, soft drinks, and having a family history of GERD.

Conclusion

This study showed the prevalence of GERD among the general population of the Eastern region, Saudi Arabia was 20.6%. Several sociodemographic and lifestyle characteristics were associated with the disease. Further studies are needed to explore the role of psychological factors in developing GERD.

Dynamics of quality of life indicators in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of complex treatment

Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues. Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy. Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III  Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment. Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10%  in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3 <0.05).Physical Functiong Scale (PF) improved by 17.9% in patients of the Comparison Group (p <0.05) and by 30.38%; 27.47%, 29.17%, respectively (p1, p2, p3 <0.05). Role Physical Scale (RP) scores improved by 25.14% in Comparison Group (p <0.05) and by 33.6 %, 22.58%  and 40.20% respectively (p1, p2, p3 <0.05). Dynamics of data in Body Pain (BP) scale improved by 21.84%  in patients of the Comparison Group (p <0.05) and by 37.28%, 25.46%, 35.92% (p1, p2, p3 <0.05).As can be seen from it, under the influence of complex therapy, the values of the Vitality (VT) increased by 17.18% in patients of Group I, by 21.93% – in Group II, by 37.87%– in Group III (p1, p2, p3 <0.05). Among patients of the Comparison Group, the influx of strength and energy felt 9.50% (p <0.05). Data of Social Functioning Scale (SF) improved by 8.8% in patients of the Comparison Group (p <0 , 05) and by 22.7%,  29.6%, 29.31%, respectively(p1, p2, p3 <0.05). Mental Health Scale (MH) improved by 17.23% in patients of Group I, by 22.41%  – in Group II, by 21.96% – in Group III (p1, p2, p3 <0.05) and 14.22% - in the Comparison Group (p <0.05). Also in patients were positive dynamics of the Role Emotional functioning scale (RE): by 27.37% in patients of Group I, by 12.36%– in Group II, by 15.7%  – in the Group III (p1, p2, p3 <0.05) and 9.05% - in patients of the Comparison Group (p < 0.05). Conclusions. Thus, the inclusion in the standard therapy of gastroesophageal reflux disease in patients with its development on the background of undifferentiated connective tissue dysplasia of magnesium lactate dihydrate in combination with pyridoxine hydrochloride ("Magne -B6 ") and calcium carbonate in combination with cholecalciferol ("Calcium-D3 Nicomed") contributed to a significant improvement in their quality of life