Which diseases are risk factors for developing gastroesophageal reflux disease?

Abstract

Gastroesophageal reflux disease (GERD) is known to present with various extraesophageal symptoms and complications. In contrast, several diseases affecting the motility of the esophagus and some approaches that alter the upper gastrointestinal tract anatomy may result in GERD. Certain diseases and conditions often mentioned with GERD will be briefly discussed in this section. Systemic SclerosisEsophageal motility is impaired in 70-90% of patients with systemic sclerosis (1-3). On histological examination, smooth muscle atrophy and fibrosis causing motor activity abnormalities in two-thirds of the distal esophagus are often determined (4). Motility studies have shown that the amplitude of peristaltic contractions decreases or that there is no peristaltic contraction in this region (5-7). Abnormal peristalsis and decreased lower esophageal sphincter (LES) pressure reduce acid clearance and prolong the contact of acid with the mucosa (8). As a result, GERD develops in patients with scleroderma. In many cross-sectional studies using different methodologies, the prevalence of GERD has been reported to be at rates of up to 70% (9-15). Diabetes MellitusFurthermore, various factors showing tendency to GERD were identified in diabetes mellitus. Among these,• Reduced salivary secretion associated with diabetic neuropathy, • Delayed gastric emptying, • Decreased acid clearance due to reduced motor activity of the esophagus/stomach related motor/autonomic neuropathy, • Increased sensory thresholds associated with sensory nerve damage of the esophagus, • Acid regurgitation caused by the increased frequency of transient LES relaxations related to neuropathy, CholecystectomyThe reservoir function of the gallbladder disappears after cholecystectomy, and bile flow becomes continuous (20,21). Qualitative changes may appear at the levels of gastrointestinal hormones (22,23). Consequently, alterations in the qualitative bile content and more frequent transient LES relaxation may occur (24). Moreover, it was thought that reflux symptoms in these patients worsen with increased biliary symptoms after cholecystectomy due to a high-fat diet intake and weight gain. Alterations in the motility of the upper gastrointestinal tract and delayed stomach emptying caused by duodenal adhesions may also contribute to GERD (25). There was no significant increase in reflux after cholecystectomy in the limited number of studies based on these data. Uyanıkoğlu et al. (26) used the impedance method and reported increased reflux after surgery and that the pH was <4% higher than that before surgery; however, it was similar to the control group. In another study, Lin et al. (27) compared patients with hernia surgery and cholecystectomy. Reduction in the reflux symptom score was 35% in patients, while it was 39% in controls (p=0.11). Sleeve GastrectomyMechanisms that may induce increased GERD in patients with GERD with sleeve gastrectomy include hypotensive LES (28), blunting of the angle of His (29), decreased gastric compliance (30), delayed gastric em...

The Frequency of Visceral and Phenotypic Markers In Patients With the Combination of Undifferentiated Connective Tissue Disease and Gastroesophageal Reflux Disease

“…This is confirmed by the fact that various abnormalities of internal organs development were detected in the majority of patients of Group II, namely in 88.0%, and only in 6.6% of the patients of Group I. The obtained data on the visceral markers of undifferentiated connective tissue dysplasia were consistent with the results of studies by other authors [15,16].…”

Allergic rhinitis is a risk factor of gastro-esophageal reflux disease regardless of the presence of asthma

“…In the literature and clinical practice, certain diseases are observed to be associated with GERD. Asthma is the most studied disease in its relationship with GERD 6 . Asthma is a complex condition characterized by variable and recurrent symptoms as the result of reversible airflow obstruction, bronchial hyper-responsiveness, and chronic airway inflammation.…”

The Effects of Diaphragmatic Breathing and Omeprazole on Respiratory Indices and Diaphragmatic Excursion in Patients with Gastroesophageal Reflux Disease

“…Reflux may decrease RI in patients and play an important role in the pathogenesis of respiratory diseases. Previous studies have reported that the incidence of GERD in patients with asthma and chronic cough is higher with various mechanisms being proposed, including microaspiration and bronchoconstriction reflexes (16)(17)(18). During the reflux, the stomach contents have reached the hypopharynx, and they may also reach the trachea.…”