Document Detail

Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux.
MedLine Citation:
PMID:  18223499     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Nonerosive gastroesophageal reflux disease (NERD) patients frequently show features of the irritable bowel syndrome (IBS). AIMS: To investigate the prevalence and intensity of bowel symptoms and their relationship to esophageal acid exposure in NERD patients. METHODS: Bowel and reflux symptoms and IBS status were assessed in NERD patients (normal upper endoscopy; esophageal pH <4 for >or= 5% of the time on 24-h pH monitoring; n=326), in relation to nonpatient controls. Bowel symptoms were scored on the 3 scales: diarrhea, constipation, and pain/gas symptoms. RESULTS: NERD and age were independently associated with bowel symptoms. NERD patients scored significantly higher than controls on all bowel scales. In a multivariate analysis, the scores on the pain/gas scale were independently associated with NERD. In NERD patients, reflux symptoms independently predicted the bowel symptoms while acid exposure did not. Forty-nine percent of the NERD patients and 18% of the controls met the criteria for IBS [IBS(+)NERD]. IBS(+)NERD patients scored significantly higher than those not meeting IBS criteria [IBS(-)] on all bowel scales. Yet IBS(-) patients scored significantly higher than controls on the scales of constipation and pain/gas. IBS(+)NERD patients scored higher than IBS(-) also on the GERD symptoms scale. CONCLUSIONS: (1) NERD patients scored significantly higher than controls on all the bowel scales; (2) Bowel symptoms were associated with reflux symptom scores, but not with acid exposure. (3) The presence of IBS features in a large proportion of NERD patients reflects a high prevalence of visceral hypersensitivity that may aggravate acid reflux symptoms.
Joseph Zimmerman; Tiberiu Hershcovici
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  42     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-21     Completed Date:  2008-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-5     Citation Subset:  IM    
Gastroenterology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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MeSH Terms
Case-Control Studies
Endoscopy, Gastrointestinal
Esophageal pH Monitoring
Follow-Up Studies
Gastric Acid / metabolism
Gastroesophageal Reflux / complications*,  diagnosis,  metabolism
Irritable Bowel Syndrome / diagnosis,  epidemiology,  etiology*
Israel / epidemiology
Prospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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