A Epidemiologic Clinical Study On Gastroesophageal Reflux Disease In Digestive Outpatients In Tongling Area Of Anhui Province

AIM: 1.To explore the clinical prevalence and the clinical symptomatic and endosco- pic features of gastroesophageal reflux disease(GERD) in digestive outpatients in Tong- ling area of Anhui Provincea. 2. To identify the risk factors of GERD around the area. 3. To analyze psychological status and quality of life on the patients with GERD.METHODS: From June 2008 to August 2008, the patients with GERD were identifi- ed out in digestive medicine consecutive outpatients crowd who visited to the three hosiptials in Tongling area of Anhui Province according to the clinical diagnostic cri- teria of GERD(RDQ score≥12)by using a validated Chinese version Reflux Disease Questionnaire(RDQ)and the Los Angeles endoscopic diagnostic criteria of reflux esophagitis(RE)and assessed the clinical prevalence and the clinical symptomatic and endoscopic features of GERD and its risk factors were analyzed. Each one patient with GERD was collected and two healthy subjects were selected as contro1 with the same age and sex in our survey. The impact of GERD on quality of life was evaluated by using the Chinese version of SF-36 and the psychological status were assessed by using Zung Self-Rating Anxiety Scale(SAS) and Zung Self-Rating Depression Scale(SDS). The database was seted up which contained all survey data with Epi Data 3.0 programs and the statistical analysis was performed with SPSS 13.0 programs.RESULTS:The 1072 patients with gastroesophageal reflux(GER) symptoms and the 199 GERD patients were identified out in the digestive medicine consecutive outpati- ents(n=7352)of the three hosiptials in the area.The clinical prevalence of GER and GERD was 14.6% and 2.7% and that of the patients with RE(n=94) and nonerosive reflux disease(NERD)(n=105) was 1.3% and 1.4% in those patients respectively.Male to female ratio of GERD was 1.76:1 and that of RE and NERD was 3.09:1and 1.14: 1 respectively.The subjects aged from 40 yrs to 60 yrs had a higher prevalence (61.8%) in GERD. The frequency of the symptoms of acid reflux and heartburn was 78.4% and 74.4% and that of regurgitation and noncardiac chest pain was 52.3% and 40.7 % respecttively in GERD subjects and some extra-esophageal symptoms were very common,such as pharyngitis(43.2%)and cough(12.6%) and hoarseness(10.7%),etc. The prevalence of endoscopic findings of NERD(n=105) was 9.8% in the1072 patients with GER symptoms and that of RE(n=94) was 8.8%. The patients with RE were mainly A-level(n=59)and B-level(n=26)while had few ones with C-level (n=4)and D-level(n=5)through endoscope. A total of 187 GERD patients were collected and a total of 374 healthy subjects were selected as contro1 with the same age and sex in our survey. Multi-factors analysis indicated that smoking and eating greasy food and bad moods were the risk factors of GERD.The subjects with poor economic conditions tended to suffer from GERD and the higher-income ones were lower-risk population of GERD. The proportion of patients with anxiety and depression status in GERD group was significantly higher than in healthy subject group and it was much higher in NERD and in female patients respectively than in RE and in male patients in further research. However, the score on quality of life of SF-36 in GERD group was significantly lower than in healthy subject group and it was much lower in NERD and in female patients respectively than in RE and in male patients.CONCLUSION:The clinical GERD prevalence was much lower in digestive medi- cine outpatients crowd of the three hosiptials in the area.Male tended to suffer from RE.The subjects aged from 40 yrs to 60 yrs were high-risk population of GERD.The major symptoms had acid reflux and heartburn included regurgitation and non-cardiac chest pain also and some extra-esophageal symptoms were very common. The RE patients were mainly A-level and B-level and the NERD patients were very common from endoscopic findings.In our study,many risk factors are involved in pathogeneses of GERD.As compared with the general population, it was very common that they had abnormal psychological status and they experienced considerable impairment in quality of life in the subjects with GERD. In particular,the proportion of patients with abnormal psychological status was much higher and the decline of quality of life was more obvious in NERD and in female patients compared with RE and male patients respectively. Psychological factors may play important roles in the production of GERD. More attention should be pay on diagnosis and treatment of associating with abnormal psychological status and improvement of quality of life in the patients with GERD.