Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients
- PMID: 29543865
- PMCID: PMC5854384
- DOI: 10.1371/journal.pone.0194466
Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients
Abstract
Objectives: To determine if a discrepancy exists between subjective symptoms and the grade of endoscopic gastroesophageal reflux disease (GERD) in diabetes mellitus (DM) patients.
Methods: All 2,884 patients who underwent esophagogastroduodenoscopy completed the modified Gastrointestinal Symptom Rating Scale (GSRS), an interview-based rating scale consisting of 16 items including a question on acid regurgitation. Patients were divided into DM and non-DM groups (1,135 and 1,749 patients, respectively). GERD was diagnosed endoscopically and graded according to the Los Angeles classification. Grade B or more severe GERD was defined as severe endoscopic GERD. The intergroup GSRS score was compared statistically.
Results: In severe endoscopic GERD patients, the prevalence of patients with a positive GSRS score in the acid regurgitation question was statistically lower in DM patients than non-DM patients. Of the 60 non-DM patients with severe endoscopic GERD, 40 patients (67%) had a positive GSRS score for acid regurgitation; however, of the 51 DM patients with severe endoscopic GERD, 23 patients (45%) had a positive GSRS score. Multivariate analysis showed that severe endoscopic GERD (OR: 2.01; 95% CI: 1.21-3.33; p = 0.0066), non-DM (OR: 0.74; 95% CI: 0.54-0.94; p = 0.0157), younger age (OR: 0.98; 95% CI: 0.97-0.99; p = 0.0125), and hiatal hernia (OR: 1.46; 95% CI: 1.12-1.90; p = 0.0042) were associated with acid regurgitation symptoms.
Conclusions: There is a discrepancy between subjective symptoms and endoscopic GERD grade in DM patients. The ability of DM patients to feel acid regurgitation may be decreased.
Conflict of interest statement
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References
-
- Drahos J, Li L, Jick SS, Cook MB. Metabolic syndrome in relation to Barrett's esophagus and esophageal adenocarcinoma: Results from a large population-based case-control study in the Clinical Practice Research Datalink. Cancer Epidemiol. 2016;42:9–14. doi: 10.1016/j.canep.2016.02.008 - DOI - PMC - PubMed
-
- Jiang X, Bernstein L, Tseng CC, Wu AH. Diabetes and risk of esophageal and gastric adenocarcinomas. Int J Cancer. 2012;131(6):1417–22. doi: 10.1002/ijc.27390 - DOI - PMC - PubMed
-
- Neale RE, Doecke JD, Pandeya N, Sadeghi S, Green AC, Webb PM, et al. Does type 2 diabetes influence the risk of oesophageal adenocarcinoma? Br J Cancer. 2009;100(5):795–8. doi: 10.1038/sj.bjc.6604908 - DOI - PMC - PubMed
-
- Sakitani K, Enooku K, Kubo H, Tanaka A, Arai H, Kawazu S, et al. Clinical characteristics of patients with diabetes mellitus and fatty liver diagnosed by liver/spleen Hounsfield units on CT scan. J Int Med Res. 2017;45(3):1208–20. doi: 10.1177/0300060517707672 - DOI - PMC - PubMed
-
- Spechler SJ, Souza RF. Barrett's esophagus. N Engl J Med. 2014;371(9):836–45. doi: 10.1056/NEJMra1314704 - DOI - PubMed
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