Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng, Zongli; Margolis, Karen L.; Liu, Simin; Tinker, Lesley F.; Ye, Weimin

doi:10.1053/j.gastro.2008.03.039

Cited by 25 publications

(27 citation statements)

References 33 publications

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“…However, it is interesting that the incidence and spontaneous loss of GORS were influenced by age, particularly for women. Postmenopausal hormone replacement therapy seems to be a risk factor for GORS and may to some extent contribute to this pattern for women 14 24. The substantial loss of GORS, not due to antireflux medication, found in the present study, is partly conflicting with the presumed chronic character of GORS and the large use of regular antireflux medication in this population.…”

Section: Discussioncontrasting

confidence: 82%

Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study

Ness-Jensen

Lindam

Lagergren

et al. 2011

Gut

115

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Objective Changes in the occurrence of gastroesophageal reflux symptoms (GERS) in the population remain uncertain. This study aimed to determine the prevalence changes, the incidence, and the spontaneous loss of GERS.Design This population-based cohort study was conducted within the NordTrøndelag health study (the HUNT study), a longitudinal series of population-based health surveys in Nord-Trøndelag County, Norway. The study base encompassed all adult residents in the county, and the participants reported the degree of GERS during the previous 12 months. The number of participants included were 58869 (64% response rate) in 1995 and 44997 (49%) in 2006-2009 persons (61%) were prospectively followed up for an average of 11 years.Results Between 1995Between -1997Between and 2006Between -2009, the prevalence of any, severe and at least weekly GERS increased by 30% (from 31.4% to 40.9%), 24% (from 5.4% to 6.7%) and 47% (from 11.6% to 17.1%), respectively. The average annual incidence of any and severe GERS was 3.07% and 0.23%, respectively. In women, but not men, the incidence of GERS increased with increasing age. The average annual spontaneous loss (not due to antireflux medication) of any and severe GERS was 2.32% and 1.22%, respectively. The spontaneous loss of GERS decreased with increasing age. Between 1995Between -1997Between and 2006Between -2009 the prevalence of GERS increased substantially. At least weekly GERS increased by 47%. The average annual incidence of severe GERS was 0.23%, and the corresponding spontaneous loss was 1.22%. The incidence and spontaneous loss of GERS were influenced by sex and age. Conclusion Occurrence of gastroesophageal reflux symptoms 4What is already known about this subject?• The prevalence of at least weekly gastroesophageal reflux symptoms (GERS) among adults has been reported to be in the range of 10-20% in the Western world.• GERS are associated with a decreased health-related quality of life.• GERS are established risk factors of adenocarcinoma of the esophagus. What are the new findings?• The prevalence of at least weekly GERS increased by 47% (from 11.6% to 17.1%) between 1995-1997 and 2006-2009. • The average annual incidence of severe GERS was 0.23%. In women, but not men, the incidence of GERS increased with increasing age.• The average annual spontaneous loss of severe GERS (not due to antireflux medication) was 1.22%. The spontaneous loss of GERS decreased with increasing age. How might it impact on clinical practice in the foreseeable future?• The increasing prevalence of GERS found in this study may call for a strengthened effort to investigate and treat this patient population, both due to the impact on health related quality of life and the increasing incidence of adenocarcinoma of the esophagus related to GERS.

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Section: Discussioncontrasting

confidence: 82%

Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study

Ness-Jensen

Lindam

Lagergren

et al. 2011

Gut

115

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show abstract

“…A study has also suggested a positive association between physical activity at work and GERD symptoms but an inverse association with recreational physical activity [84]. In our study, the associations between occupational physical activity and frequency or severity of GERD symptoms were mixed.…”

Section: Discussioncontrasting

confidence: 45%

Determinants of Gastroesophageal Reflux Disease, Including Hookah Smoking and Opium Use– A Cross-Sectional Analysis of 50,000 Individuals

et al. 2014

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BackgroundGastroesophageal 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.MethodsWe 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.ResultsApproximately 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).ConclusionGERD 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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“…Initially, when the women with GERD symptoms who received conjugated estrogen treatment and a placebo were compared, estrogen therapy was not shown to affect the severity of existing symptoms. When the patients receiving conjugated estrogen+medroxyprogesterone and a placebo were compared, no increase was observed in the incidence of symptomatic GERD (2.4% for both) or in the severity and frequency of existing symptoms (18). In another retrospective cohort study, the relative risk was investigated for the use of PPIs or for GERD in women who used HRT (n=22101) and did not use HRT (n=29081); when multiple regression analysis was performed, a significant association was found between estrogen monotherapy and GERD risk (OR: 1.49, 95% CI 1.18-1.89, p<0.001).…”

Section: Hormone Replacement Therapy and Oral Contraceptive Drugsmentioning

confidence: 95%

“…In a randomized controlled study in which a to- Inducing/Facilitating Esophageal Inflammation&Damage tal of 40 centers participated, conjugated estrogen was given to 5310 of 10739 women who underwent postmenopausal hysterectomy, and a placebo was given to the remaining 5429 women; conjugated estrogen + medroxyprogesterone was given to 8506 of 16608 women who did not undergo hysterectomy, and a placebo was given to the remaining 8102 women. One year later, the subjects were evaluated in terms of the incidence of GERD symptoms and the progression of GERD (18). The incidence of new, moderate, and severe symptomatic GERD development was found to be slightly higher in the conjugated estrogen group in comparison to the placebo group (4.2% vs. 3.1%, OR: 1.35, 95% CI 0.99-1.85).…”

Section: Hormone Replacement Therapy and Oral Contraceptive Drugsmentioning

confidence: 99%

Which drugs are risk factors for the development of gastroesophageal reflux disease?

Mungan

Simsek

2020

Turk J Gastroenterol

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Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Abstract: Background & Aims-An association between female hormones and symptomatic gastroesophageal reflux disease (GERD) and may be modified by obesity is suggested but not proven. Factors affecting GERD progression, however, are largely unknown.

Cited by 25 publications

References 33 publications

Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study

Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study

Determinants of Gastroesophageal Reflux Disease, Including Hookah Smoking and Opium Use– A Cross-Sectional Analysis of 50,000 Individuals

Which drugs are risk factors for the development of gastroesophageal reflux disease?

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