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Digestive Diseases and Sciences

, Volume 53, Issue 8, pp 2027–2032 | Cite as

Diet, Lifestyle and Gender in Gastro-Esophageal Reflux Disease

  • Maria Pina DoreEmail author
  • Emmanouil Maragkoudakis
  • Ken Fraley
  • Antonietta Pedroni
  • Vincenza Tadeu
  • Giuseppe Realdi
  • David Y. Graham
  • Giuseppe Delitala
  • Hoda M. Malaty
Original Paper

Abstract

Background Studies indicate that gastro-esophageal reflux disease (GERD) is associated with obesity, smoking, esophagitis, diet, and lifestyle. Aim To identify risk factors associated with GERD among patients presenting to a tertiary GI clinic in Italy. Methods Patients with a first diagnosis of GERD based on heartburn and/or regurgitation and/or esophagitis at the endoscopic examination were enrolled. A control group with neither GERD symptoms nor esophagitis was enrolled from the same hospital. Each subject completed a questionnaire including demographic information, lifestyle (e.g., exercise, alcohol, coffee, chocolate, and soda consumption, smoking, having large meals), and frequency of bowel movement. For each participant the body mass index (BMI) was calculated. Results Five hundred subjects were enrolled including 300 GERD patients and 200 controls. Females had significantly higher prevalence of GERD than males (66 vs. 48%, P = 0.001, OR = 2.1, 95% CI = 1.5–3.1). There was an inverse relationship between the level of education and presence of GERD (76% of GERD patients has completed only elementary school (OR = 2.1, 95% CI = 1.7–4.9). Obesity (BMI of ≥95th percentile for their age/gender specific) was significantly related to GERD (OR = 1.8, P = 0.01). None of the other variables studied showed significant associations with GERD. Logistic regression analysis showed that BMI ≥95th percentile, gender, and low education level were significant risk factors for GERD. Conclusions Understanding the epidemiology and risk factors for GERD in a region is the first step in designing prevention and treatment strategies.

Keywords

Exercise Alcohol Coffee Chocolate Smoking Soda consumption 

References

  1. 1.
    Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J (2004) Prevalence of gastro-oesophageal reflux symptoms and the influence of age and sex. Scand J Gastroenterol 39:1040–1045PubMedCrossRefGoogle Scholar
  2. 2.
    Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J (2004) Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut 53:1730–1735PubMedCrossRefGoogle Scholar
  3. 3.
    Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J (2003) Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA 290:66–72PubMedCrossRefGoogle Scholar
  4. 4.
    Watanabe Y, Fujiwara Y, Shiba M, Watanabe T, Tominaga K, Oshitani N, Matsumoto T, Nishikawa H, Higuchi K, Arakawa T (2003) Cigarette smoking and alcohol consumption associated with gastro-oesophageal reflux disease in Japanese men. Scand J Gastroenterol 38:807–811PubMedCrossRefGoogle Scholar
  5. 5.
    Locke GR III, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ III (1999) Risk factors associated with symptoms of gastroesophageal reflux. Am J Med 106:642–649PubMedCrossRefGoogle Scholar
  6. 6.
    Lee KS, Park CY, Meng KH, Bush A, Lee SH, Lee WC, Koo JW, Chung CK (1998) The association of cigarette smoking and alcohol consumption with other cardiovascular risk factors in men from Seoul, Korea. Ann Epidemiol 8:31–38PubMedCrossRefGoogle Scholar
  7. 7.
    Dore MP, Pedroni A, Pes GM, Maragkoudakis E, Tadeu V, Pirina P, Realdi G, Delitala G, Malaty HM (2007) Effect of antisecretory therapy on atypical symptoms in gastroesophageal reflux disease. Dig Dis Sci 52:463–468PubMedCrossRefGoogle Scholar
  8. 8.
    Rey E, Elola-Olaso CM, Rodriguez-Artalejo F, Locke GR III, Diaz-Rubio M (2006) Prevalence of atypical symptoms and their association with typical symptoms of gastroesophageal reflux in Spain. Eur J Gastroenterol Hepatol 18:969–975PubMedCrossRefGoogle Scholar
  9. 9.
    Cameron AJ, Lagergren J, Henriksson C, Nyren O, Locke GR III, Pedersen NL (2002) Gastroesophageal reflux disease in monozygotic and dizygotic twins. Gastroenterology 55–59Google Scholar
  10. 10.
    Hampel H, Abraham NS, El-Serag HB (2005) Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 143:199–211PubMedGoogle Scholar
  11. 11.
    Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J (2004) Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut 53:1730–1735PubMedCrossRefGoogle Scholar
  12. 12.
    Pandolfino JE, El-Serag HB, Zhang Q, Shah N, Ghosh SK, Kahrilas PJ (2006) Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 130:639–649PubMedCrossRefGoogle Scholar
  13. 13.
    Veugelers PJ, Porter GA, Guernsey DL, Casson AG (2006) Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Dis Esophagus 19:321–328PubMedCrossRefGoogle Scholar
  14. 14.
    Mohammed I, Cherkas LF, Riley SA, Spector TD, Trudgill NJ (2003) Genetic influences in gastro-oesophageal reflux disease: a twin study. Gut 52:1085–1089PubMedCrossRefGoogle Scholar
  15. 15.
    Isolauri J, Laippala P (1995) Prevalence of symptoms suggestive of gastro-oesophageal reflux disease in an adult population. Ann Med 27:67–70PubMedCrossRefGoogle Scholar
  16. 16.
    Kotzan J, Wade W, Yu HH (2001) Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a medicaid population. Pharm Res 18:1367–1372PubMedCrossRefGoogle Scholar
  17. 17.
    Kostikas K, Papaioannou AI, Gourgoulianis KI (2006) BMI and gastroesophageal reflux in women. N Engl J Med 354:2340–2348CrossRefGoogle Scholar
  18. 18.
    Kahrilas PJ, Gupta RR (1990) Mechanisms of acid reflux associated with cigarette smoking. Gut 4–10Google Scholar
  19. 19.
    Vitale GC, Cheadle WG, Patel B, Sadek SA, Michel ME, Cuschieri A (1987) The effect of alcohol on nocturnal gastroesophageal reflux. JAMA 258:2077–2079PubMedCrossRefGoogle Scholar
  20. 20.
    Pehl C, Waizenhoefer A, Wendl B, Schmidt T, Schepp W, Pfeiffer A (1999) Effect of low and high fat meals on lower esophageal sphincter motility and gastroesophageal reflux in healthy subjects. Am J Gastroenterol 94:1192–1196PubMedCrossRefGoogle Scholar
  21. 21.
    Hills JM, Aaronson PI (1991) The mechanism of action of peppermint oil on gastrointestinal smooth muscle. Gastroenterology 101:55–65PubMedGoogle Scholar
  22. 22.
    Murphy DW, Castell DO (1988) Chocolate and heartburn: evidence of increased esophageal acid exposure after chocolate ingestion. Am J Gastroenterol 83:633–636PubMedGoogle Scholar
  23. 23.
    Brazer SR, Onken JE, Dalton CB, Smith JW, Schiffman SS (1995) Effect of different coffees on esophageal acid contact time and symptoms in coffee-sensitive subjects. Physiol Behav 57:563–567PubMedCrossRefGoogle Scholar
  24. 24.
    Hamoui N, Lord RV, Hagen JA, Theisen J, Demeester TR, Crookes PF (2006) Response of the lower esophageal sphincter to gastric distention by carbonated beverages. J Gastrointest Surg 10:870–877PubMedCrossRefGoogle Scholar
  25. 25.
    Pehl C, Pfeiffer A, Wendl B, Kaess H (1998) Different effects of white wine and red wine on lower esophageal sphincter pressure and gastroesophageal reflux. Scand J Gastroenterol 33:118–122PubMedCrossRefGoogle Scholar
  26. 26.
    Pehl C, Wendl B, Pfeiffer A, Schmidt T, Kaess H (1993) Low-proof alcoholic beverages and gastroesophageal reflux. Dig Dis Sci 38:93–96PubMedCrossRefGoogle Scholar
  27. 27.
    Jozkow P, Wasko-Czopnik D, Medras M, Paradowski L (2006) Gastroesophageal reflux disease and physical activity. Sports Med 36:385–391PubMedCrossRefGoogle Scholar
  28. 28.
    DeVault KR, Castell DO (2005) Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 100:190–200PubMedCrossRefGoogle Scholar
  29. 29.
    Kaltenbach T, Crockett S, Gerson LB (2006) Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach. Arch Intern Med 166:965–971PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Maria Pina Dore
    • 1
    • 2
    Email author
  • Emmanouil Maragkoudakis
    • 1
  • Ken Fraley
    • 3
  • Antonietta Pedroni
    • 1
  • Vincenza Tadeu
    • 1
  • Giuseppe Realdi
    • 4
  • David Y. Graham
    • 2
  • Giuseppe Delitala
    • 1
  • Hoda M. Malaty
    • 2
  1. 1.Istituto di Clinica MedicaUniversita` di SassariSassariItaly
  2. 2.Baylor College of MedicineHoustonUSA
  3. 3.Children Nutrition Research CenterHoustonUSA
  4. 4.Clinica Medica PrimaUniversity of Padova PaduaItaly

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