Overlap of Erosive and Non-erosive Reflux Diseases With Functional Gastrointestinal Disorders According to Rome III Criteria

Abstract

Background/AimsGastroesophageal reflux disease (GERD) is increasing in Asian countries. Functional dyspepsia (FD) or irritable bowel syndrome (IBS) are also prevalent and commonly overlapped with GERD. This study was conducted to compare the proportion and risk factors for overlapping reflux esophagitis (RE) and non-erosive reflux disease (NERD) with functional gastrointestinal disorders (FGIDs).MethodsA total of 2,388 [male, 55.9%; mean age (± SD), 43.2 years (± 8.4)] Korean subjects who underwent the upper endoscopy for health screening were prospectively included. The subjects were asked about demographic, medical and social history by using a structured questionnaire, and FD and IBS were assessed according to the Rome III criteria.ResultsThe subjects with RE were 286 (12.0%, male 88.5%, 42.8 years) and 74 subjects had NERD (3.1%) while the prevalence of FD and IBS were 8.1% and 10.1%, respectively. The proportion of FD and IBS in NERD was higher than that of RE (74.3% vs. 10.5%, p = 0.000; 41.9% vs. 11.2%, p = 0.000, respectively). The epigastric pain syndrome (EPS) was more prevalent than postprandial distress syndrome in NERD. According to multiple regression analysis, high somatization score and the presence of FD increased the odd ratio for NERD. However, male gender and current smoker were significant risk factors for RE.ConclusionsCompared to RE, NERD is more frequently overlapped with FD, especially EPS, and also are associated with significantly increased frequency of IBS. Our data draws attention to the possibility of subgrouping FGIDs and GERD to be important in understanding the pathophysiology of these conditions.

Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities

“…The 65.5% prevalence of GERD is within the range of 11-79% described in other studies (5,34). According to endoscopic evaluation the majority of the cases were classified as NERD, as expected (35). However the present study was unable to confirm the association between comorbidity and psychological distress in IBS, as reported by several authors (5,36).…”

Estimating the Burden of Irritable Bowel Syndrome: Analysis of a Nationwide Korean Database

“…In addition, combination therapy was frequently used in IBS patients due to symptom heterogeneity. 33,34 In contrast, a third of the total direct medical costs were consumed by in-patient stays for evaluation, diagnosis and treatment. 35 Distribution of medical costs for IBS patients was skewed by high healthcare utilization.…”

Association Between SLC6A4 Serotonin Transporter Gene Lainked Polymorphic Region and ADRA2A −1291C>G and Irritable Bowel Syndrome in Korea

“…Although the proportion of IBS-C seems widely variable in Asia, 50 the recent study which was conducted in Korea based on ROME III criteria reported that the proportion of IBS-C was only 12.0%. 23 When the necessary sample size for detecting the significant association was calculated based on the observed genotypic frequencies (with a power of 80% and a level of significance of 5% in unmatched case-control [1:1]; OR, 2.0), the smallest number of sample size among the 5 polymorphisms was approximately 150 in control and total IBS group, respectively. However, the sample size of IBS patients in the present study was far less than the expected value and this inevitably reduced statistical power.…”

“…All of them completed a validated bowel disease questionnaire, which was translated from the original Bowel Disease Questionnaire (BDQ) into Korean (Korean BDQ). 23 The questionnaire contained 56 gastrointestinal symptom-related items which based on the Rome III criteria. Socio-demographic status, past medical history, smoking, alcohol habit, marital status, educational level and employment status were also included.…”