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GERD Symptoms in the General Population: Prevalence and Severity Versus Care-Seeking Patients

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Abstract

Background

Prior estimates suggest that up to 40 % of the US general population (GP) report symptoms of gastroesophageal reflux disease (GERD). However, symptoms in the GP versus patients seeking care for gastrointestinal (GI) complaints have not been compared. We estimated the prevalence and severity of GERD symptoms in the GP versus GI patients, and identified predictors of GERD severity. We hypothesized that similar to functional GI disorders, psychosocial factors would predict symptom severity in GERD as much, or perhaps more, than care-seeking behavior alone.

Methods

We compared the prevalence of heartburn and regurgitation between a sample from the US GP and patients seeking GI specialty care. We compared GERD severity between groups using the NIH PROMIS® GERD scale. We then performed multivariable regression to identify predictors of GERD severity.

Results

There was no difference in the prevalence of heartburn between the GP and patient groups (59 vs. 59 %), but regurgitation was more common in patients versus GP (46 vs. 39 %; p = 0.004). In multivariable regression, having high visceral anxiety (p < 0.001) and being divorced or separated (p = 0.006) were associated with higher GERD severity.

Conclusions

More than half of a GP sample reports heartburn—higher than previous series and no different from GI patients. Although regurgitation was more prevalent in patients versus the GP, there was no difference in GERD severity between groups after adjusting for other factors; care seeking in GERD appears related to factors beyond symptoms, including visceral anxiety.

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Abbreviations

GI:

Gastrointestinal

PRO:

Patient-reported outcome

HRQOL:

Health-related quality of life

PROMIS:

Patient-Reported Outcome Measurement Information System

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Acknowledgments

NIH/NIAMS U01 AR057936A, the National Institutes of Health through the NIH Roadmap for Medical Research Grant (AR052177). Puja Khanna was supported by Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grant NIAMS 1 T32 AR053463 and ACR Research and Education Foundation Clinical Investigator Fellowship Award 2009_11. Dinesh Khanna was also supported by NIAMS K24 AR063120. Ron Hays was also supported by NIH/NIA Grants P30-AG028748 and P30-AG021684, and NCMHD Grant 2P20MD000182. Lin Chang was also supported by NIDDK P50 DK64539.

Conflict of interest

Brennan Spiegel has received grant support from Ironwood, Amgen, and Shire Pharmaceuticals, and served as a consultant to Ironwood, Forest, and Takeda North America. Dinesh Khanna has served as consultant and/or received grant support from Actelion, Astra-Zeneca, Bayer, BMS, DIGNA, Genentech, Gilead, InterMune, Merck, Takeda, Savient, and United Therapeutics. Ron D. Hays has served as a consultant to Amgen, Allergan, Pfizer, and the Critical Path Institute. Gil Melmed has served as a consultant for Abbvie and Jannsen, is on the speaker’s bureau for Prometheus and Abbott, and has received research support from Pfizer. Lin Chang has served as a consultant to Ironwood, Forest, Prometheus, Salix, Takeda North America and has received grant support from Shire and Ironwood.

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Authors and Affiliations

  1. Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Bldg 115, Room 215, Los Angeles, CA, 90073, USA

    Erica Cohen & Brennan Spiegel

  2. Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Roger Bolus, Lin Chang & Brennan Spiegel

  3. Division of Rheumatology, University of Michigan, Ann Arbor, MI, USA

    Dinesh Khanna & Puja Khanna

  4. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Ron D. Hays

  5. Department of Health Services, UCLA School of Public Health, Los Angeles, CA, USA

    Ron D. Hays

  6. Department of Gastroenterology, Cedars-Sinai Medical Center, West Hollywood, CA, USA

    Erica Cohen & Gil Y. Melmed

  7. Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Lin Chang

  8. UCLA/VA Center for Outcomes Research and Education, Los Angeles, CA, USA

    Roger Bolus & Brennan Spiegel

Authors
  1. Erica Cohen
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  2. Roger Bolus
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  3. Dinesh Khanna
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  4. Ron D. Hays
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  5. Lin Chang
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  6. Gil Y. Melmed
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  7. Puja Khanna
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  8. Brennan Spiegel
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Corresponding author

Correspondence to Brennan Spiegel.

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Disclaimer The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veteran Affairs.

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Cohen, E., Bolus, R., Khanna, D. et al. GERD Symptoms in the General Population: Prevalence and Severity Versus Care-Seeking Patients. Dig Dis Sci 59, 2488–2496 (2014). https://doi.org/10.1007/s10620-014-3181-8

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  • DOI: https://doi.org/10.1007/s10620-014-3181-8

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