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. 2014 Oct;59(10):2488-96.
doi: 10.1007/s10620-014-3181-8. Epub 2014 May 9.

GERD symptoms in the general population: prevalence and severity versus care-seeking patients

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GERD symptoms in the general population: prevalence and severity versus care-seeking patients

Erica Cohen et al. Dig Dis Sci. 2014 Oct.

Abstract

Background: Prior estimates suggest that up to 40% of the US general population (GP) report symptoms of gastroesophageal reflux disease (GERD). However, symptoms in the GP versus patients seeking care for gastrointestinal (GI) complaints have not been compared. We estimated the prevalence and severity of GERD symptoms in the GP versus GI patients, and identified predictors of GERD severity. We hypothesized that similar to functional GI disorders, psychosocial factors would predict symptom severity in GERD as much, or perhaps more, than care-seeking behavior alone.

Methods: We compared the prevalence of heartburn and regurgitation between a sample from the US GP and patients seeking GI specialty care. We compared GERD severity between groups using the NIH PROMIS(®) GERD scale. We then performed multivariable regression to identify predictors of GERD severity.

Results: There was no difference in the prevalence of heartburn between the GP and patient groups (59 vs. 59%), but regurgitation was more common in patients versus GP (46 vs. 39%; p = 0.004). In multivariable regression, having high visceral anxiety (p < 0.001) and being divorced or separated (p = 0.006) were associated with higher GERD severity.

Conclusions: More than half of a GP sample reports heartburn-higher than previous series and no different from GI patients. Although regurgitation was more prevalent in patients versus the GP, there was no difference in GERD severity between groups after adjusting for other factors; care seeking in GERD appears related to factors beyond symptoms, including visceral anxiety.

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Figures

Fig. 1
Fig. 1
NIH PROMIS® GERD Scale
Fig. 1
Fig. 1
NIH PROMIS® GERD Scale
Fig. 2
Fig. 2
Independent predictors of GERD symptom severity. This figure shows differences in NIH PROMIS GERD scores between those with versus without the variable of interest, after controlling for other factors. In this figure, the X-axis represents the mean score. Every 10 units on the PROMIS scale equal one standard deviation from the mean

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