Concomitant functional dyspepsia and irritable bowel syndrome decrease health-related quality of life in gastroesophageal reflux disease

Abstract

Objective: Previous studies have reported an overlap between gastroesophageal reflux symptoms, functional dyspepsia (FD) and irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of FD and IBS in gastroesophageal reflux disease (GERD) and the effect on health-related quality of life (HRQoL).

Material and methods: FD and IBS prevalence and HRQoL were assessed by means of questionnaires in 215 referred and 48 non-referred (non-care-seeking) GERD patients, proven with 24-h pH-metry. HRQoL in 131 matched controls was used for comparison.

Results: In this group of GERD patients 25% had FD (Dutch general population 13-14%), 35% had IBS (Dutch general population 0.6-6%) and 5% had both FD and IBS. Only 35% had neither FD nor IBS. Among referred GERD patients, the prevalence of FD and IBS was higher (p=0.002 versus non-referred). Compared with controls, GERD patients without FD/IBS had lower HRQoL scores on only one of the nine SF-36 subscales (p<or=0.001); GERD+FD patients had lower scores on six subscales (p<or=0.0005); GERD+IBS patients had lower scores on eight subscales (p <0.0005) and GERD+FD+IBS patients had lower scores on seven subscales (p<or=0.001). Compared with patients with GERD only, GERD+FD patients had lower scores on five subscales (p<or=0.001); GERD+IBS patients had lower scores on eight subscales (p <0.0005) and GERD+FD+IBS patients had lower scores on six subscales (p<or=0.001).

Conclusions: In patients with proven GERD, FD and IBS are more prevalent than in the general population. This prevalence is higher among care-seeking GERD patients. Only those GERD patients with concomitant FD/IBS have a much lower HRQoL. This suggests that in GERD, when properly treated, HRQoL is affected mainly by concomitant functional disorders and not by GERD itself.