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Risk factors associated with functional esophageal disorders (FED) versus gastroesophageal reflux disease (GERD)

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

A Correction to this article was published on 15 April 2024

This article has been updated

Abstract

Introduction

Despite the high prevalence of typical symptoms of gastroesophageal reflux disease (GERD), approximately 30% of patients have functional esophageal disorders (FED) on ambulatory reflux monitoring, which may include reflux hypersensitivity (RH; defined as physiologic acid exposure but temporally correlated symptoms of reflux), or functional heartburn (FH; defined as physiologic acid exposure and negative symptom correlation). There are limited epidemiological data characterizing these conditions. We investigated demographic and socioeconomic factors as well as medical comorbidities which may predispose to FED versus pathologic GERD.

Methods

Adult patients with reflux symptoms for at least 3 months were studied with 24-h pH-impedance testing from 11/2019 to 3/2021. Participants were categorized into pathologic GERD, FH, or RH using pH-impedance data and reported symptom correlation. Demographic data, including age, gender, race/ethnicity, zip code, insurance status, and medical comorbidity data were retrospectively retrieved from the electronic medical record on all participants.

Results

229 patients were included. Non-Hispanic Asian ethnicity (OR 5.65; p = 0.01), underweight BMI (OR 7.33; p = 0.06), chronic pain (OR 2.33; p < 0.01), insomnia (OR 2.83; p = 0.06), and allergic rhinitis (OR 3.90; p < 0.01) were associated with a greater risk for FED. Overweight BMI (OR 0.48; p = 0.03) and alcohol use (OR 0.57; p = 0.06) were associated with a decreased risk for FED.

Discussion

This is the first report of a greater risk of FED in patients with underweight BMI, insomnia, chronic pain, allergic rhinitis, or of Asian or Hispanic ethnicities. The weak associations between female gender and anxiety are corroborated in other studies. Our findings enable clinicians to better screen patients with reflux for this disorder.

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No funding supported study design and conduct; in the collection, management, analysis, and interpretation of data; in the preparation, review, or approval of the report; or in the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Medicine, New York University Langone Health, 247 E 28th Street, New York, NY, 10016, USA

    Moniyka Sachar

  2. Department of Biostatistics, New York University School of Public Health, New York, USA

    Marina Mautner Wizentier, Emma Risner & Hannah Asmail

  3. Division of Gastroenterology & Hepatology, Department of Medicine, Center for Esophageal Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA

    Mathew Omara, Shreya Chablaney, Abraham Khan & Rita Knotts

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  1. Moniyka Sachar
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Contributions

MS contributed to data collection and writing of the manuscript. MW contributed to data analysis and writing of the manuscript. ER contributed to data analysis and organization of the manuscript. HA contributed to data analysis of the study. MO contributed to data curation. SC contributed to editing of manuscript. AK contributed to editing of manuscript. RK contributed conceptualization of project and editing of the manuscript and study supervision.

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Correspondence to Moniyka Sachar.

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Moniyka Sachar, Marina Mautner Wizentier, Emma Risner, Hannah Asmail, Mathew Omara, Shreya Chablaney, Abraham Khan, Rita Knotts have no conflicts of interest or financial ties to disclose.

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Sachar, M., Mautner Wizentier, M., Risner, E. et al. Risk factors associated with functional esophageal disorders (FED) versus gastroesophageal reflux disease (GERD). Surg Endosc (2024). https://doi.org/10.1007/s00464-024-10714-0

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