Risk factors associated with symptoms of gastroesophageal reflux

Locke, G. Richard; Talley, Nicholas J.; Fett, Sara L.; Zinsmeister, Alan R.; Melton, L. Joseph

doi:10.1016/s0002-9343(99)00121-7

Cited by 452 publications

(358 citation statements)

References 41 publications

Supporting

Mentioning

289

Contrasting

Unclassified

Order By: Relevance

“…However, several studies have demonstrated the validity and reliability of these questions in identifying cases of GERD. 1,2,11,[26][27][28] Symptoms assessed by questionnaire have correlated with objective complications of GERD, such as esophagitis and esophageal adenocarcinoma. 29,30 Furthermore, to improve our specificity for GERD we restricted our primary endpoint to women who reported at least weekly symptoms.…”

Section: Commentmentioning

confidence: 99%

Postmenopausal Hormone Use and Symptoms of Gastroesophageal Reflux

Jacobson

Moy

Colditz

et al. 2009

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

Context-Previous studies suggest that elevated levels of estrogen and progesterone, either through endogenous or exogenous sources, increase gastroesophageal reflux.Objective-To evaluate the relationship between symptoms of gastroesophageal reflux disease and postmenopausal hormone therapy, including the use of selective estrogen receptor modulators and over-the-counter hormone preparations.Design, setting, and participants-Prospective cohort study of 51,637 postmenopausal women enrolled in the Nurses' Health Study who provided data on the use of hormone therapy biennially since 1976, and information about symptoms of gastroesophageal reflux in 2002.Main outcome measure-Self-reported symptoms of heartburn or acid-regurgitation occurring at least once a week in the previous year (reflux symptoms).Results-Among eligible participants, 12,018 (23%) women reported reflux symptoms. Compared to women who never used postmenopausal hormones, the multivariate odds ratio (OR) for the risk of reflux symptoms was 1.46 (95% CI 1.36-1.56) for past hormone users, 1.66 (95% CI 1.54-1.79) for current users of estrogen only, and 1.41 (95% CI 1.29-1.54) for current users of combined estrogen and progesterone. The risk of reflux symptoms increased significantly with increasing estrogen dose (P < 0.001) and increasing duration of estrogen use (P < 0.001). Moreover, current selective estrogen receptor modulator users experienced an OR of 1.39 (95% CI 1.22-1.59) for reflux symptoms, and women currently using over-the-counter hormone preparations had an OR of 1.37 (95% CI 1.16-1.62). Conclusions-Postmenopausal use of estrogens, selective estrogen receptor modulators, or overthe-counter hormone preparations is associated with an increased risk of symptoms of gastroesophageal reflux. This suggests a hormonal component to the pathophysiology of gastroesophageal reflux in women.

show abstract

Section: Commentmentioning

confidence: 99%

Postmenopausal Hormone Use and Symptoms of Gastroesophageal Reflux

Jacobson

Moy

Colditz

et al. 2009

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

show abstract

“…Body mass index (BMI; in kg/m 2 ) was calculated and was categorized as underweight (<21, equivalent to below the 5th percentile of our study participants) and, according to the World Health Organization classification, normal (21 to <25), overweight (25)(26)(27)(28)(29)(30), class 1 obesity (>30-35), class 2 obesity (>35-40), and class 3 obesity (>40, equivalent to above the 95th percentile of our study participants). Waist circumference and waist-to-hip ratio were categorized into 6 categories, based on their distribution percentiles among our study participants with equivalent to <5th (referred to as lowest), 5th-25th (referred to as normal and used as reference), 26th-50th, 51st-75th, 76th-95th, and >95th (referred to as highest) percentiles.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Because the outcome was rare (≈3%), the odds ratio (OR) closely approximates the relative risk. Because hormone therapy decreases waist circumference, [19][20][21] which is associated with GER, 13,15,16,25 to examine the effect of hormone therapy on symptomatic GER through pathways other than the waist circumference pathway, we adjusted for waist circumference change in separate analyses. To study the progress of symptomatic GER, we calculated a symptom change score, which was the difference of score (none = 0, mild = 1, moderate = 2, severe = 3) at 1 year to that at baseline.…”

Section: Statistical Analysesmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng

Margolis

Liu³

et al. 2008

Gastroenterology

View full text Add to dashboard Cite

show abstract

“…(1)(2)(3)(4)(5)(6)(7)(8)(9) The odds ratios (ORs) of GERS among smokers compared to non-smokers have been in the range of 1.3 to 2.5. Tobacco smoking increases the risk of GERS by reducing the lower esophageal sphincter pressure, facilitating gastric acid to reach the esophagus, (10)(11)(12) and reducing the salivary bicarbonate secretion, which neutralizes the acidity of the gastric contents.…”

Section: Introductionmentioning

confidence: 99%

Tobacco Smoking Cessation and Improved Gastroesophageal Reflux: A Prospective Population-Based Cohort Study: The HUNT Study

Ness-Jensen

Lindam

Lagergren

et al. 2014

American Journal of Gastroenterology

View full text Add to dashboard Cite

Objective Tobacco smoking increases the risk of gastroesophageal reflux symptoms (GERS), but whether tobacco smoking cessation improves GERS is unclear. The aim of this study was to clarify if tobacco smoking cessation improves GERS. DesignThe study was based on the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted from -1997-2009 Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported whether they had heartburn or acid regurgitation. The association between tobacco smoking cessation and improvement in GERS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by antireflux medication, and the results were adjusted for sex, age, body mass index (BMI), alcohol consumption, education, and physical exercise. Subgroup analyses were also stratified by BMI.Results Among individuals using antireflux medication at least weekly, cessation of daily tobacco smoking was associated with improvement in GERS from severe to no or minor complaints (adjusted OR 1.78, 95% CI 1.07 to 2.97), compared with persistent daily smoking. This association was present among individuals within the normal range of BMI (OR 5.67, 95% CI 1.36 to 23.64), but not among overweight individuals. There was no association between tobacco smoking cessation and GERS status among individuals with minor GERS or individuals using antireflux medication less than weekly.  Tobacco smoking is associated with an increased the risk of GERS. Conclusion The effect of tobacco smoking cessation on GERS is not clear. 2) What is new here This study did not find any association between tobacco smoking cessation and improvement in GERS in individuals not using regular antireflux medication. Tobacco smoking cessation was associated with an improvement in severe GERS in individuals of normal weight using regular antireflux medication.

show abstract

Risk factors associated with symptoms of gastroesophageal reflux

Cited by 452 publications

References 41 publications

Postmenopausal Hormone Use and Symptoms of Gastroesophageal Reflux

Postmenopausal Hormone Use and Symptoms of Gastroesophageal Reflux

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Tobacco Smoking Cessation and Improved Gastroesophageal Reflux: A Prospective Population-Based Cohort Study: The HUNT Study

Contact Info

Product

Resources

About