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Effect of sex on symptoms associated with gastroesophageal reflux.

Abstract

BACKGROUND

Previous research suggests that females have a poorer outcome than do males after surgery for gastroesophageal reflux.

OBJECTIVE

To evaluate reflux and esophageal symptoms in males and females in a community sample and in patients undergoing antireflux surgery.

DESIGN

Face-to-face interview.

SETTING

A South Australian community.

PARTICIPANTS

Random sample of 2973 individuals from the community and 2153 patients presenting for antireflux surgery.

MAIN OUTCOME MEASURES

In a random sample of 2973 individuals from the community, the prevalence of reflux and other esophageal symptoms was determined and compared with symptoms in 2153 patients presenting for antireflux surgery. Identical questions were used to assess frequency and severity of heartburn and dysphagia and medication use. Analog scales assessed heartburn and dysphagia (0 indicating no symptoms and 10, severe symptoms). Outcomes for males vs females were compared across both groups.

RESULTS

In the community, females were more likely to report heartburn, and when reported, symptom severity was higher. The prevalence of dysphagia was similar for males and females, although females reported higher dysphagia scores for solid foods. A similar proportion of males and females took antireflux medications. Females presenting for antireflux surgery were, on average, 7 years older than males, had a higher body mass index, and had higher heartburn and dysphagia symptom scores. At endoscopy, men were more likely to have ulcerative esophagitis and Barrett esophagus, and at surgery they were less likely to have a hiatal hernia.

CONCLUSIONS

Significant differences were noted between males and females in the frequency and severity of gastroesophageal reflux-associated symptoms in the community and in patients presenting for surgery. These might reflect differences in symptom perception, which explain previously reported better outcomes in men undergoing antireflux surgery.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, Flinders University, Flinders Medical Centre, Bedford Park, South Australia, Australia.

    , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Cohort Studies
    Deglutition Disorders
    Female
    Gastroesophageal Reflux
    Heartburn
    Humans
    Male
    Middle Aged
    Prevalence
    Severity of Illness Index
    Sex Factors
    South Australia
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22006875

    Citation

    Chen, Zhen, et al. "Effect of Sex On Symptoms Associated With Gastroesophageal Reflux." Archives of Surgery (Chicago, Ill. : 1960), vol. 146, no. 10, 2011, pp. 1164-9.
    Chen Z, Thompson SK, Jamieson GG, et al. Effect of sex on symptoms associated with gastroesophageal reflux. Arch Surg. 2011;146(10):1164-9.
    Chen, Z., Thompson, S. K., Jamieson, G. G., Devitt, P. G., & Watson, D. I. (2011). Effect of sex on symptoms associated with gastroesophageal reflux. Archives of Surgery (Chicago, Ill. : 1960), 146(10), pp. 1164-9. doi:10.1001/archsurg.2011.248.
    Chen Z, et al. Effect of Sex On Symptoms Associated With Gastroesophageal Reflux. Arch Surg. 2011;146(10):1164-9. PubMed PMID: 22006875.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of sex on symptoms associated with gastroesophageal reflux. AU - Chen,Zhen, AU - Thompson,Sarah K, AU - Jamieson,Glyn G, AU - Devitt,Peter G, AU - Watson,David I, PY - 2011/10/19/entrez PY - 2011/10/19/pubmed PY - 2011/12/30/medline SP - 1164 EP - 9 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 146 IS - 10 N2 - BACKGROUND: Previous research suggests that females have a poorer outcome than do males after surgery for gastroesophageal reflux. OBJECTIVE: To evaluate reflux and esophageal symptoms in males and females in a community sample and in patients undergoing antireflux surgery. DESIGN: Face-to-face interview. SETTING: A South Australian community. PARTICIPANTS: Random sample of 2973 individuals from the community and 2153 patients presenting for antireflux surgery. MAIN OUTCOME MEASURES: In a random sample of 2973 individuals from the community, the prevalence of reflux and other esophageal symptoms was determined and compared with symptoms in 2153 patients presenting for antireflux surgery. Identical questions were used to assess frequency and severity of heartburn and dysphagia and medication use. Analog scales assessed heartburn and dysphagia (0 indicating no symptoms and 10, severe symptoms). Outcomes for males vs females were compared across both groups. RESULTS: In the community, females were more likely to report heartburn, and when reported, symptom severity was higher. The prevalence of dysphagia was similar for males and females, although females reported higher dysphagia scores for solid foods. A similar proportion of males and females took antireflux medications. Females presenting for antireflux surgery were, on average, 7 years older than males, had a higher body mass index, and had higher heartburn and dysphagia symptom scores. At endoscopy, men were more likely to have ulcerative esophagitis and Barrett esophagus, and at surgery they were less likely to have a hiatal hernia. CONCLUSIONS: Significant differences were noted between males and females in the frequency and severity of gastroesophageal reflux-associated symptoms in the community and in patients presenting for surgery. These might reflect differences in symptom perception, which explain previously reported better outcomes in men undergoing antireflux surgery. SN - 1538-3644 UR - https://www.unboundmedicine.com/medline/citation/22006875/Effect_of_sex_on_symptoms_associated_with_gastroesophageal_reflux_ L2 - https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.2011.248 DB - PRIME DP - Unbound Medicine ER -