Abstract：
BACKGROUND: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：尽管胃食管反流病（GERD）的典型症状患病率很高，在动态反流监测中，大约30%的患者患有功能性食道疾病(FED)，其中可能包括反流超敏反应（RH；定义为生理酸暴露，但与反流的症状时间相关），或功能性胃灼热（FH；定义为生理酸暴露和阴性症状相关性）。描述这些状况的流行病学数据有限。我们调查了人口统计学和社会经济因素以及可能导致FED与病理性GERD的医学合并症。
方法：从2019年11月至2021年3月，对患有反流症状至少3个月的成年患者进行24小时pH-阻抗测试。参与者被分为病理性GERD，FH,或RH使用pH-阻抗数据和报告的症状相关性。人口统计数据,包括年龄,性别,种族/民族,邮政编码,保险状况,我们从所有参与者的电子病历中回顾性检索了医疗合并症数据.
结果：纳入229例患者。非西班牙裔亚洲种族（OR5.65；p=0.01），体重不足的BMI（OR7.33；p=0.06），慢性疼痛（OR2.33;p<0.01），失眠（OR2.83；p=0.06），和过敏性鼻炎（OR3.90;p<0.01）与FED的风险更高相关。超重BMI（OR0.48;p=0.03）和饮酒（OR0.57;p=0.06）与FED风险降低相关。
结论：这是第一份关于体重不足的患者发生FED风险更大的报告，失眠,慢性疼痛,过敏性鼻炎,或亚裔或西班牙裔。其他研究证实了女性与焦虑之间的弱关联。我们的发现使临床医生能够更好地筛查反流患者的这种疾病。
方法：从2019年11月至2021年3月，对患有反流症状至少3个月的成年患者进行24小时pH-阻抗测试。参与者被分为病理性GERD，FH,或RH使用pH-阻抗数据和报告的症状相关性。人口统计数据,包括年龄,性别,种族/民族,邮政编码,保险状况,我们从所有参与者的电子病历中回顾性检索了医疗合并症数据.
结果：纳入229例患者。非西班牙裔亚洲种族（OR5.65；p=0.01），体重不足的BMI（OR7.33；p=0.06），慢性疼痛（OR2.33;p<0.01），失眠（OR2.83；p=0.06），和过敏性鼻炎（OR3.90;p<0.01）与FED的风险更高相关。超重BMI（OR0.48;p=0.03）和饮酒（OR0.57;p=0.06）与FED风险降低相关。
结论：这是第一份关于体重不足的患者发生FED风险更大的报告，失眠,慢性疼痛,过敏性鼻炎,或亚裔或西班牙裔。其他研究证实了女性与焦虑之间的弱关联。我们的发现使临床医生能够更好地筛查反流患者的这种疾病。
