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Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux.
J Clin Gastroenterol. 2008 Mar; 42(3):261-5.JC

Abstract

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.

Authors+Show Affiliations

Gastroenterology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18223499

Citation

Zimmerman, Joseph, and Tiberiu Hershcovici. "Bowel Symptoms in Nonerosive Gastroesophageal Reflux Disease: Nature, Prevalence, and Relation to Acid Reflux." Journal of Clinical Gastroenterology, vol. 42, no. 3, 2008, pp. 261-5.
Zimmerman J, Hershcovici T. Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux. J Clin Gastroenterol. 2008;42(3):261-5.
Zimmerman, J., & Hershcovici, T. (2008). Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux. Journal of Clinical Gastroenterology, 42(3), 261-5. https://doi.org/10.1097/MCG.0b013e31802fc591
Zimmerman J, Hershcovici T. Bowel Symptoms in Nonerosive Gastroesophageal Reflux Disease: Nature, Prevalence, and Relation to Acid Reflux. J Clin Gastroenterol. 2008;42(3):261-5. PubMed PMID: 18223499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux. AU - Zimmerman,Joseph, AU - Hershcovici,Tiberiu, PY - 2008/1/29/pubmed PY - 2008/5/28/medline PY - 2008/1/29/entrez SP - 261 EP - 5 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 42 IS - 3 N2 - 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. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/18223499/Bowel_symptoms_in_nonerosive_gastroesophageal_reflux_disease:_nature_prevalence_and_relation_to_acid_reflux_ L2 - http://dx.doi.org/10.1097/MCG.0b013e31802fc591 DB - PRIME DP - Unbound Medicine ER -