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Type: Journal article
Title: Prevalence of gastro-oesophageal reflux disease with upper gastrointestinal symptoms without heartburn and regurgitation
Author: Vakil, N.
Wernersson, B.
Ohlsson, L.
Dent, J.
Citation: United European Gastroenterology Journal, 2014; 2(3):173-178
Publisher: SAGE Publications
Issue Date: 2014
ISSN: 2050-6406
Statement of
Nimish Vakil, Börje Wernersson, Lis Ohlsson, John Dent
Abstract: BACKGROUND: Symptomatically 'silent' gastro-oesophageal reflux disease (GORD) may be underdiagnosed. OBJECTIVE: To determine the prevalence of untreated GORD without heartburn and/or regurgitation in primary care. METHODS: Patients were included if they had frequent upper gastrointestinal symptoms and had not taken a proton pump inhibitor in the previous 2 months (Diamond study: NCT00291746). GORD was diagnosed based on the presence of reflux oesophagitis, pathological oesophageal acid exposure, and/or a positive symptom-acid association probability. Patients completed the Reflux Disease Questionnaire (RDQ) and were interviewed by physicians using a prespecified symptom checklist. RESULTS: GORD was diagnosed in 197 of 336 patients investigated. Heartburn and/or regurgitation were reported in 84.3% of patients with GORD during the physician interviews and in 93.4% of patients with GORD when using the RDQ. Of patients with heartburn and/or regurgitation not identified at physician interview, 58.1% (18/31) reported them at a 'troublesome' frequency and severity on the RDQ. Nine patients with GORD did not report heartburn or regurgitation either at interview or on the RDQ. CONCLUSIONS: Structured patient-completed questionnaires may help to identify patients with GORD not identified during physician interview. In a small proportion of consulting patients, heartburn and regurgitation may not be present in those with GORD.
Keywords: Bloating
gastro-oesophageal reflux disease
oesophageal endoscopy
oesophageal pH monitoring
upper abdominal pain
Rights: © Author(s) 2014 Reprints and permissions:
DOI: 10.1177/2050640614532458
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