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The Impact Of Diet And Mental Factors On Reflux Symptoms And Nutritional Status Of Patients With Gastroesophageal Reflux Disease

Posted on:2014-09-13Degree:MasterType:Thesis
Country:ChinaCandidate:M W SongFull Text:PDF
GTID:2284330431975033Subject:Internal Medicine
Abstract/Summary:PDF Full Text Request
Objectives:Gastroesophageal reflux disease (GERD) as a common disease of the digestive system, significantly affects the quality of life of patients, which may cause patients’ dietary intake unbalance or clinical malnutrition. Combining dietary treatment and/or paying more attention to patients who have psychological problems may be more effective than a single drug treatment. The purpose of my study: A retrospective questionnaire is for GERD to know the risk factors (including diet, lifestyle and psychological factors) revelant to the disese, and concern about the risk factors of patients on GERD symptoms and patients’ nutritional status. And by the questionnaire, we analyze and compare difference made by risk factors in the patient’s nutritional status and psychological factors between erosive esophagitis (RE) and non-erosive reflux disease (NERD), which can give the doctor a suggestion on the treatment of GERD diaease.Methods:GERD Patients with heartburn, acid reflux, regurgitation or non-cardiac chest pain more than three months were included from November2011to September2012, whose diagnosis consistent with The Montreal Definition (only enrolling RE patients and NERD patients), at the same time,the GERD patients didn’t have peptic ulcer disease, systemic or local systemic diseases, gastrointestinal obstruction and gastrointestinal surgery. All patients were required to complete the questionnaire (including reflux symptoms, extraesophageal symptoms), common foods inducing reflux symptoms, unhealthy lifestyle and Mini Nutritional Assessent (MNA) questionnaire.All the patients required endoscopy, that according to the results of endoscopy was divided into NERD and RE.Results:1.118patients were selected, including RE50and NERD68. The average age of the patients was (46.8±11.32) years old, the male accounts for54.20%. The three most common Extra-esophageal symptoms were pharyngolaryngitis(63.60%), foreign body in pharynx (55.90%), snoring(47.50%). The total symptom score (TSS总) was more severity in female(P=0.018), and MNA worse than man (P=0.008), and there were nothing difference in another demographic data on TSS&and MNA.2. Wine(59.62%), sweets(59.22%), carbonated beverages(50.94%), spicy foods (48.68%), fatty foods(45.45%) were very common factors in patients. Also the eating more food(64.84%) and late eating(49.30%). We found "rice","fruit","onion or chive","milk" and "yogurt" had great effect on reflux symptoms. The "rice","fruit" and "milk" made influnce on acid reflux (P<0.05). Patients who said "wheat bran","fruit","onion or chive","milk","bean products","uncooked food","cold food" and "coffe" could induce reflux symptoms had more severious regurgitation (P<0.05),"yogurt"and "coffe" made an impact on chest pain.Patients with cold catching had worse symptoms (P=0.022);there were a relation between "catch cold"/" midnight snack"and acid reflux,"catch cold" and regurgitation. patients with emotional problems had more severe symptoms(P=0.008), poorer nutritional status (P=0.000).And patients with tension where more severe symptoms (P=0.018) and patients in depression with poor nutrition (P=0.000). The relationship between the TSS总and scores of MNA was negatively correlated, positively correlated between scores of symptoms and number of food inducing reflux symptoms.3. Compared patients with RE, female in NERD patients were predominant (P=0.028). BMI over24kg/m2in RE was risk factor (P=0.020). The NERD had higher scores of total symptoms in people who thought "rice" and "wheat bran" could induce reflux symptoms,"rice"," the flour food" and "fruit"made much impact on heartburn in NERD (P<0.05)."cold food" made much impact on chest pain. The ratio of the presence of emotional problems, the degree of symptoms,and nutritional level were no difference between the two groups(P>0.05). In group of RE, patients with emotional problems had a lower scores of MNA(P=0.010), especially with depression(P=0.000). Tension on the patient’s symptoms and nutritional level had no significant effect (P<0.05). Compared patients with no emotional problems in NERD group,they had more severe symptoms and poorer nutrition(P<0.05).Moreover, patients with tension only had severe symptoms (P=0.034), and patients with depression only had poorer nutrition(P=0.000). Conclusion:1. Wine, sweets, carbonated drinks, spicy foods, greasy foods, eating more and late eating are the really common risks of GERD patients,which have influence on reflux symptoms.2. Mental psychological factors cannot be ignored,and they can make an impact on patients’ symptoms and nutritional status.3. There are difference between RE and NERD in symptoms and nutritional status when induced by diet or mental psychological factors.
Keywords/Search Tags:Gastroesophageal reflux disease, diet, lifestyle, mental factors, reflux symptom, nutritional status
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