Prevalence and Socioeconomic Impact of Upper Gastrointestinal Disorders in the United States: Results of the US Upper Gastrointestinal Study
ABSTRACT This study examined the prevalence of upper gastrointestinal (GI) symptoms and symptom groupings and determined impact on disability days in a nationally representative US sample.
A telephone survey of 21,128 adults was conducted including questions about the presence of upper GI symptoms during the past 3 months. Respondents were categorized as symptomatic (ie, reported GI symptoms once per month) or asymptomatic. The survey included questions about missed work, leisure activity, or household activity days. Symptom groupings were identified by using factor analysis, and cluster analysis was used to assign respondents into distinct groups on the basis of these symptom groupings.
The prevalence of an average of 1 or more upper GI symptoms during the past 3 months was 44.9%. The most common symptoms experienced during the past 3 months were early satiety, heartburn, and postprandial fullness. Factor analysis identified 4 symptom groupings: (1) heartburn/regurgitation; (2) nausea/vomiting; (3) bloating/abdominal pain; and (4) early satiety/loss of appetite. Five respondent clusters were identified; the largest clusters were primarily early satiety/fullness (44%) and gastroesophageal reflux disease-like symptoms (28%). Two small clusters reflected nausea and vomiting (7%) and a heterogeneous symptom profile (4%). Symptomatic respondents reported significantly more missed work, leisure, and household activity days than asymptomatic respondents (all P < .0001).
Factor analysis separated GI symptoms into groupings reflecting gastroesophageal reflux disease and dyspepsia: early satiety, postprandial fullness, and loss of appetite; bloating and abdominal pain/discomfort; and nausea and vomiting. These upper GI symptoms were associated with significant loss of work and activity days.
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ABSTRACT: With the exception of predominant heartburn, the management of upper abdominal symptoms not caused by an organic disorder remains a challenge. Systematic reviews of large trials show that suppressing acid secretion and eradicating Helicobacter pylori, prokinetics, and antidepressants have inconsistent effects on the treatment of functional dyspepsia. This inconsistent therapeutic efficacy has been attributed to the heterogeneity of patients, and the contribution of multiple mechanisms to development of symptoms. To achieve greater therapeutic efficacy, it may be necessary to target the therapeutic approach to a specific pathophysiology, such as impaired gastric emptying.Gastroenterology Clinics of North America 10/2007; 36(3):649-64, xi-x. DOI:10.1016/j.gtc.2007.07.001 · 1.92 Impact Factor
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ABSTRACT: There is a perception that the prevalence of gastroesophageal reflux disease (GERD) is increasing, but few studies have directly tackled this issue. By using a systematic approach, this review aimed to assess objectively whether the prevalence of GERD is changing with time. First, population-based studies that reported the prevalence of at least weekly heartburn and/or acid regurgitation were subjected to a time-trend analysis with a Poisson regression model. Second, population-based studies reporting the prevalence of GERD symptoms at 2 time points in the same source population were reviewed. Third, longitudinal studies that charted the prevalence of GERD symptoms and esophagitis in primary and secondary care were examined. The Poisson model revealed a significant (P < .0001) trend for an increase in the prevalence of reflux symptoms in the general population over time. Separately, significant increases with time were found for North America (P = .0005) and Europe (P < .0001) but not Asia (P = .49). Studies of the same source population over time indicated an increase in the prevalence of GERD in the U.S., Singapore, and China but not Sweden. An increase in the prevalence of GERD or esophagitis was found in the majority of longitudinal studies. There is evidence that the prevalence of GERD has increased during the past 2 decades. If this trend continues, it could contribute to the rapidly increasing incidence of more serious complications associated with GERD, such as esophageal adenocarcinoma, as well as costs to healthcare systems and employers.Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 01/2007; 5(1):17-26. DOI:10.1016/j.cgh.2006.09.016 · 6.53 Impact Factor