Prevalence, clinical spectrum and atypical symptoms of gastro-oesophageal reflux in Argentina: a nationwide population-based study.

Department of Gastroenterology, Hospital Nacional Prof. Dr Alejandro Posadas, El Palomar, Buenos Aires, Argentina.
Alimentary Pharmacology & Therapeutics (Impact Factor: 5.48). 08/2005; 22(4):331-42. DOI: 10.1111/j.1365-2036.2005.02565.x
Source: PubMed

ABSTRACT Population-based data on gastro-oesophageal reflux in Latin America are lacking.
To assess gastro-oesophageal reflux symptom prevalence, clinical spectrum and association with the atypical symptoms in our country.
Gastro-oesophageal reflux self-report questionnaires validated at Mayo Clinic, USA, were submitted to a sample of 1000 residents (aged 18-80 years) from 17 representative geographical areas of Argentina. The samples were selected and stratified according to age, gender, geographical areas and size of town of residence provided by the Argentine Bureau of Statistics and Census.
The overall prevalence of any typical gastro-oesophageal reflux symptom experienced in the previous year was 61.2% (95% CI, 57.9-64.6), the prevalence of frequent gastro-oesophageal reflux symptoms was 23.0% (95% CI, 20.1-25.9) and the prevalence of gastro-oesophageal reflux disease was 11.9% (95% CI, 9.6-14.1). Frequent gastro-oesophageal reflux symptoms were associated with dysphagia (OR 2.12, 95% CI, 1.27-3.54, P < 0.01), globus (OR 2.22, 95% CI, 1.35-3.66, P < 0.01) and non-cardiac chest pain (OR 1.55, 95% CI, 1.04-2.31, P < 0.05).
In Argentina, typical symptoms of gastro-oesophageal reflux are highly prevalent at the national level, and frequent gastro-oesophageal reflux symptoms are significantly associated with dysphagia, globus and non-cardiac chest pain.

Download full-text


Available from: Graciela Salis, May 14, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Repetitive airway occlusion during sleep in patients with obstructive sleep apnoea (OSA) results in the generation of negative intrathoracic pressures and ends in arousal, both of which may predispose to reflux during sleep (nocturnal reflux). We aimed to determine and compare the prevalence of nocturnal reflux symptoms and their sleep-associated risk factors in untreated OSA patients, OSA patients using continuous positive airway pressure (CPAP) therapy, and the general population. Gastro-oesophageal reflux and sleep questionnaires were completed by 1116 patients with polysomnography diagnosed OSA and by 1999 participants of the 2007 Busselton population health survey. Of the OSA patients, 137 completed the reflux questionnaire before and after treatment. Risk of OSA in the general population was assessed using the Berlin score. The prevalence of frequent (>weekly) nocturnal reflux symptoms was increased (P<0.001) in OSA patients (10.2%) versus the general population (5.5%), in individuals from the general population at high (8.7%) versus low risk (4.3%) of OSA and in patients with severe (13.9%) versus mild OSA (5.1%). Frequent nocturnal reflux symptoms were associated with high risk (general population) (OR 1.9, P<0.01) and severity of OSA (OSA population) OR 3.0, severe versus mild OSA, P<0.001) after correcting for age, gender and body mass index. Treatment with CPAP decreased the prevalence of reflux symptoms significantly. In conclusion, the prevalence of nocturnal reflux symptoms is increased in those with or suspected of having OSA. This association is independent of other risk factors including age, gender and body mass index, suggesting a causal relationship between OSA and nocturnal reflux.
    Journal of Sleep Research 03/2011; 20(1 Pt 2):241-9. DOI:10.1111/j.1365-2869.2010.00843.x · 2.95 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aim: The aim of this study was to describe the frequency of non-specific symptoms of gastroesophageal reflux and association of these symptoms with gastroesophageal reflux disease (GERD) in Iranian population. Background: GERD is a common gastrointestinal disorder, worldwide. Some patients with GERD have no symptoms while others may have non-specific symptoms. Patients and methods: This study was designed as a cross-sectional and population based evaluation that was conducted on 782 cases that selected by random sampling in northeast region of Tehran province. Relation between non-specific symptoms and GERD was assessed using χ2 test. The odds ratios (OR) and 95% CI were calculated for each symptom. Results: Most common non-specific symptom in subjects under study, was abdominal pain with a female preponderance. Abdominal pain, globus sensation, cough & dyspnea, and halitosis were statistically associated to GERD. There was no relationship between age and non-specific symptoms. Conclusion: In summary, this study showed that non-specific symptoms are common in our country that strongly related to gastroesophageal reflux disease, therefore, these symptoms should be considered as a basic in diagnostic procedure.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A standard approach to the problem of finding optimal policies for controlled Markov processes with average cost is based on the existence of solutions to an average optimality equation, or an average optimality inequality (Cavazos-Cadena and Sennott (1992), Sennott (1999)). In the latter, conditions are imposed on the solutions to the inequalities such that if one such solution is found, then optimal policies are obtained for all values of the state. In Hernandez-Lerma and Lasserre, (1994), such conditions are relaxed, at the expense that perhaps optimal policies are characterized for only a proper subset of the state space. Motivated by the work in Hernandez-Lerma and Lasserre, optimality inequality results were presented in Hernandez-Hernandez and Marcus, (1999), for the risk-sensitive case, purposely trying to emulate in the risk-sensitive case what had been done previously for the risk-neutral case. However, as it is illustrated in the sequel, the results in Hernandez-Hernandez and Marcus exhibit an acute fragility not present in their risk- counterparts.
    Decision and Control, 2002, Proceedings of the 41st IEEE Conference on; 01/2003