No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Curry Induces Acid Reflux and Symptoms in Gastroesophageal Reflux Disease
Abstract
There are limited data on the effect of curry on gastroesophageal reflux disease (GERD). Our objective was to study the effects of curry on GERD.
Symptomatic non-erosive gastroesophageal reflux disease (NERD) patients and healthy volunteers underwent ambulatory 24-h esophageal pH monitoring before consumption of either 400 or 800 ml of curry; they were monitored for 3 h thereafter for changes in esophageal pH and upper abdominal symptoms. Selected volunteers were monitored similarly after water ingestion.
In total, 25 NERD patients (23 males; mean age, 45 years) and 19 volunteers (13 males; mean age, 22 years) participated. In both patients and volunteers, curry ingestion induced more esophageal acid exposure than did ingestion of a similar volume of water. Curry induced significantly more esophageal acid exposure in NERD patients than in volunteers. Upper abdominal symptoms and esophageal acid exposure were more severe and persisted longer in patients than in volunteers.
Curry induced more acid reflux and caused worse symptoms in patients with NERD than in healthy individuals. Patients with NERD should be advised to avoid curry ingestion.
... Curry also significantly worsened reflux symptoms from 15 to 150 min after ingestion [23]. An RCT pilot study showed that alow vera syrup alleviated heartburn symptoms, but the effect was smaller than that of omeprazole and ranitidine [24]. A randomized cross-over study in 12 NERD patients evaluating the effect of functional foods (marine collagen peptides, wheat oligopeptides, vegetable fat powder, glucose-maltodextrin, isomaltooligosaccharide, extracts of Amomum villosum, tangerine peel, and jujube, composite minerals, vitamins, and other minor ingredients) revealed a lower number of postprandial reflux symptoms compared to a standard meal (median 0 vs. 3 events) [12]. ...
Background: International guidelines recommend dietary interventions as one of the most important treatments for patients with gastroesophageal reflux disease (GERD). Evidence to confirm the efficacy of these treatment modalities is lacking. The present study aims to evaluate the efficacy of dietary interventions on GERD-related outcomes evaluated in intervention studies on GERD patients. Methods: A systematic review and meta-analysis was performed according to PRISMA. The PubMed/MEDLINE, Web of Sciences, and Scopus databases were utilized for the literature search. Two independent researchers searched for relevant publications published up until June 2023. Intervention studies evaluating the efficacy of dietary interventions in patients with GERD were included. Results: A total of 577 articles were identified during the initial literature search. After reviewing, 21 studies with 16 different types of dietary interventions were included in the analysis. The interventions were divided into low-carbohydrate diets (3 studies), high-fat diets (2 studies), speed of eating studies (3 studies), low-FODMAP diets (2 studies), and other interventions (12 studies). A meta-analysis could be performed for low-carbohydrate diets and speed of eating interventions. Low-carbohydrate diets resulted in a significant reduction in esophageal acid exposure time (mean difference = −2.834%, 95% confidence interval (CI): −4.554 to −1.114), while a slow speed of eating did not lead to a lower percentage of reflux events compared to fast eating (risk ratio = 1.044, 95% CI: 0.543–2.004). Most other interventions showed positive effects in only a single study. Conclusion: Low-carbohydrate diets showed a significant improvement in GERD-related outcomes, while a slow eating speed did not result in a reduction in reflux events. The overall evidence regarding dietary interventions in GERD remains scarce. High-quality, long-term RCTs are still required to confirm the effects of dietary interventions in GERD patients.
... Its acidic content makes volume reflux of such foods hard to control with proton pump inhibitors. Lee et al. showed that curry-induced acid reflux actually reported worse reflux symptoms than patients with reflux disease not caused by curry [24]. This may give us a clue to explain a higher incidence of conversion surgery in the Indian population. ...
Background
Laparoscopic sleeve gastrectomy (LSG) has become the preferred bariatric procedure in many countries. However, there is one shortcoming of LSG in the long-term follow-up, and this is the onset of gastro-esophageal reflux disease (GERD) and erosive esophagitis (EE). Conversion to Roux-en-Y gastric bypass (RYGB) is considered an option in patients unresponsive to medical therapy. Currently, there is no evidence of EE improvement or resolution after conversion surgery. In this study, we objectively evaluate the effectiveness of RYGB in management of EE with upper endoscopy (EGD) to identify the significant variables in patients with GERD symptoms post LSG refractory to medical therapy and require conversion surgery.Methods
Over a period of 11 years (2008–2019) at Singapore General Hospital, we retrospectively reviewed a prospectively collected database of a cohort of patients whom had conversion surgery to RYGB for refractory GERD and EE after LSG. Patient’s endoscopic findings and demographic and anthropometric data were analyzed.ResultsWe identified a total of 14 patients who underwent LSG to RYGB conversions for endoscopic proven erosive esophagitis in our unit during the study period. Eight patients (57.1%) had concurrent hiatal hernia repaired. Nine (64.3%) patients were females. The median age of patients in this cohort was 44 (range 30–61) years. Mean weight and BMI were 87.7 kg (± 19.2) and 32.8 (± 3.09) kg/m2, respectively, on the day of conversion surgery. The median time between LSG and revision to RYGB was 36 (range 6–68) months. Seven patients (50%) had complete resolution of GERD symptoms after conversion, and 6 patients (42.9%) had partial resolution. Six out of 7 patients had complete resolution of EE. There were 4 anastomotic strictures (28.6%). Older patients, Indian ethnicity, present of hiatal hernia and lower weight loss after initial LSG were more likely to undergo conversion surgery.Conclusion
Conversion to RYGB after LSG is clinically relevant and may be a feasible solution if patients have ongoing GERD refractory to medical therapy. Ninety-three percent of our patients achieved complete resolution of their GERD symptoms and significant improvement of erosive esophagitis with significant weight loss after conversion. This study has important implications as LSG is increasingly being performed and a proportion of these will need revision surgery for various reasons, particularly GERD which is extremely prevalent.
... However, studies are generally inconclusive to show a clear association between the ingestion of particular aliments and the occurrence of specific pathophysiological abnormalities [12,15]. Nevertheless, patients often report the rising of reflux symptoms after the ingestion of specific alimentary foods [1,[16][17][18][19][20][21][22][23][24]. For this reason, in presence of typical symptoms, it is generally recommended to reduce the intake of such foods, for instance, orange, mint, chocolate, suspected to facilitate the symptomatology. ...
Background
The relationship between aliments and pathophysiological abnormalities leading to gastroesophageal reflux disease (GERD) symptoms elicitation is unclear. Nevertheless, patients often report symptoms after ingestion of specific foods.AimsTo identify in primary care setting the presence of foods able to trigger GERD symptoms, and evaluate whether a consequent specific food elimination diet may result in clinical improvement.Methods
Diagnosis of GERD and quantification of reflux symptoms were done according to GERD-Q questionnaire (positive when > 8). During clinical data collection, patients were asked to report aliments associated with their symptoms. Also, a precompiled list of additional foods was administered to them. Then, patients were requested to eliminate the specific foods identified, and to come back for follow-up visit after 2 weeks when GERD-Q questionnaire and clinical data collection were repeated.ResultsOne-hundred GERD (mean GERD-Q score 11.6) patients (54 females, mean age 48.7 years) were enrolled. Eighty-five patients reported at least one triggering food, mostly spicy foods (62%), chocolate (55%), pizza (55%), tomato (52%), and fried foods (52%). At follow-up visit, the diagnosis of GERD was confirmed in only 55 patients, and the mean GERD-Q score decreased to 8.9. Heartburn reporting decreased from 93 to 44% of patients, while regurgitation decreased from 72 to 28%. About half of the patients agreed to continue with only dietary recommendations.Conclusions
Most patients with GERD can identify at least one food triggering their symptoms. An approach based on abstention from identified food may be effective in the short term.
... Fried and spicy foods have been suggested as two of the most common precipitating factors of GERD symptoms and LES insufficiency [65][66][67]. Precisely, chilli causes refluxassociated symptoms, including heartburn, chest discomfort, nausea, belching, abdominal discomfort and distension [68,69]. Regarding some reports, chilli and spicy foods do not affect the overall esophageal motility but only alter the LES tonicity [70][71][72]. ...
Objective
To develop clinical tools assessing the refluxogenic potential of foods and beverages (F&B) consumed by patients with laryngopharyngeal reflux (LPR).
Methods
European experts of the LPR Study group of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological societies were invited to identify the components of Western European F&B that would be associated with the development of LPR. Based on the list generated by experts, four authors conducted a systematic review to identify the F&B involved in the development of esophageal sphincter and motility dysfunctions, both mechanisms involved in the development of gastroesophageal reflux disease and LPR. Regarding the F&B components and the characteristics identified as important in the development of reflux, experts developed three rational scores for the assessment of the refluxogenic potential of F&B, a dish, or the overall diet of the patient.
Results
Twenty-six European experts participated to the study and identified the following components of F&B as important in the development of LPR: pH; lipid, carbohydrate, protein composition; fiber composition of vegetables; alcohol degree; caffeine/theine composition; and high osmolality of beverage. A total of 72 relevant studies have contributed to identifying the Western European F&B that are highly susceptible to be involved in the development of reflux. The F&B characteristics were considered for developing a Refluxogenic Diet Score (REDS), allowing a categorization of F&B into five categories ranging from 1 (low refluxogenic F&B) to 5 (high refluxogenic F&B). From REDS, experts developed the Refluxogenic Score of a Dish (RESDI) and the Global Refluxogenic Diet Score (GRES), which allow the assessment of the refluxogenic potential of dish and the overall diet of the LPR patient, respectively.
Conclusion
REDS, RESDI and GRES are proposed as objective scores for assessing the refluxogenic potential of F&B composing a dish or the overall diet of LPR patients. Future studies are needed to study the correlation between these scores and the development of LPR according to impedance–pH study.
... Ingestion of curry induced reflux symptoms in both GORD patients and healthy volunteers. Additionally, it also exacerbated pathological reflux in patients with GORD [Lim et al. 2011]. In contrast, a cross-sectional study by Pandeya and colleagues showed no association between spicy food consumption and GORD symptoms [Pandeya et al. 2012]. ...
Several lifestyle and dietary factors are commonly cited as risk factors for gastro-oesophageal reflux disease (GORD) and modification of these factors has been advocated as first-line measures for the management of GORD. We performed a systematic review of the literature from 2005 to the present relating to the effect of these factors and their modification on GORD symptoms, physiological parameters of reflux as well as endoscopic appearances. Conflicting results existed for the association between smoking, alcohol and various dietary factors in the development of GORD. These equivocal findings are partly due to methodology problems. There is recent good evidence that weight reduction and smoking cessation are beneficial in reducing GORD symptoms. Clinical and physiological studies also suggest that some physical measures as well as modification of meal size and timing can also be beneficial. However, there is limited evidence for the role of avoiding alcohol and certain dietary ingredients including carbonated drinks, caffeine, fat, spicy foods, chocolate and mint.
... Use of supplements was also not significant. Many studies have shown that dietary pattern and environment are associated with increase risk for gastroesophageal reflux symptoms and GORD 13,18,[20][21] . Unfortunately, we did not inquire into family history or dietary pattern. ...
Gastro-oesophageal reflux disorders (GORD) are common in Western countries and has been reported to be increasing in the East. This study assessed the prevalence of GORD among the Nepalese residing in the Brunei Darussalam.
Nepalese residing in two areas were invited to participate in this cross sectional questionnaire study. GORD was considered to be present if there was any heartburn, regurgitation or both experienced at least monthly that were associated with impairment of quality of life measures. Overall, 304 out of 320 (female 68.4%) with completed questionnaire were available for analysis.
Overall 45.1% had reported symptoms of gastroesophageal reflux: heartburn and regurgitation (21.4%), heartburn alone (9.2%) and regurgitations alone (14.5%). However, only 7.2% had GORD. GORD was significantly more common among women (p=0.005), being shorter in height (p=0.013), those with co morbid conditions (p=0.023) and previously had endoscopy (p=0.006). There were no difference in age, duration of residence, body mass index (kg/m2), alcohol intake, tobacco and supplements use (all p>0.05). GORD was also significantly associated with the presence of psychosomatic symptoms such as backache, depression, fatigue, headache and insomnia (all p<0.05). Subjects with GORD also experienced significantly more other upper gastrointestinal complaints such as nausea, vomiting, early satiety, post-prandial fullness, and abdominal bloating (all p<0.05).
The prevalence of GORD among Nepalese residing in Brunei Darussalam was 7.2%. Certain subjects' profiles were associated with GORD and patients with GORD were likely to experience more psychosomatic and other gastrointestinal symptoms.
... Between the identified foods that are reported with reflux-related symptoms are noodles, spicy foods, fatty meals, sweets, alcohol, breads, carbonated drinks, caffeinated drinks, 14 and curry. 15 In spite of the wide range of medications currently used in GERD management with PPIs remain the mainstay of treatment. In this respect some clinicians reported their experiences that the generic has sometimes shown less effective than the corresponding branded PPIs. ...
he occurrence of esophageal and gastric motor dysfunctions happens, when the software of the esophagus and the stomach is injured. This is really a program previously established in the enteric nervous system as a constituent of the newly called neurogastroenterology. The enteric nervous system is composed of small aggregations of nerve cells, enteric ganglia, the neural connections between these ganglia, and nerve fibers that supply effectors tissues, including the muscle of the gut wall. The wide range of enteric neuropathies that includes esophageal achalasia and gastroparesis highlights the importance of the enteric nervous system. A classification of functional gastrointestinal disorders based on symptoms has received attention. However, a classification based solely in symptoms and consensus may lack an integral approach of disease. As an alternative to the Rome classification, an international working team in Bangkok presented a classification of motility disorders as a physiology-based diagnosis. Besides, the Chicago Classification of esophageal motility was developed to facilitate the interpretation of clinical high-resolution esophageal pressure topography studies. This review covers exclusively the medical and surgical management of the esophageal and gastric motor dysfunction using evidence from well-designed studies. Motor control of the esophagus and the stomach, motor esophageal and gastric alterations, treatment failure, side effects of PPIs, overlap of gastrointestinal symptoms, predictors of treatment, burden of GERD medical management, data related to conservative treatment vs. antireflux surgery, and postsurgical esophagus and gastric motor dysfunction are also taken into account.
Gastroesophageal reflux disease (GERD) was considered an uncommon disease in Asia in the past but is now a rapidly emerging disease. Various factors underlie this rise, which can be broadly divided into environmental and host genetic factors. Among these factors, the rapid increase in overweight and obesity in the region is probably the most important. Other factors include lifestyle changes which have accompanied “Westernization” of the Asian population, including a change in diet, smoking, alcohol consumption, and physical activity, but these are often hard to measure. A decline in Helicobacter pylori infection across the region likely plays an important role as well. Ethnic differences and differences in the rate of rise of GERD between ethnic groups in the region point to a key role for host genetic factors. Genetic polymorphisms which involve the interleukin-1B gene have been reported, but more work needs to be done in this area.
Dietary factors have important effects on gastrointestinal function. Any factor that increases gastric distention
(e. g. meal volume), slows gastric emptying (e. g. calorie load), or promotes acid secretion (e. g. calcium, certain amino acids) increases the risk of gastroesophageal reflux. Further factors that modulate esophageal sensitivity (e. g., fat content, alcohol) may have an impact on the frequency and severity of reflux symptoms. Specific dietary interventions that reduce esophageal acid exposure and reflux symptoms include weight loss, not lying down after a meal, reduction of meal size, and avoiding high-calorie, high-fat foods. If dietary interventions are not sufficient to control symptoms, then over-the-counter (OTC) medications can provide effective treatment for individuals with intermittent and/or mild reflux symptoms. These include simple antacids that neutralize gastric acid and antacid–alginate preparations (e. g. Gaviscon®) that displace the so-called “acid pocket” at the esophagogastric junction and suppress both acid and nonacid reflux events. For more severe symptoms, proton pump inhibitors (PPI) are available without prescription in many countries. The availability of OTC treatment medications can provide appropriate and, almost certainly, cost-effective treatment for some people. However, for patients who choose not to visit a medical practitioner, it is important that the presence of alarm symptoms (e. g., dysphagia, weight loss) or therapy-resistant disease is recognized by the pharmacist dispensing these medications. In this situation specialist attention and endoscopic investigation are always required. Furthermore, the frequency and severity of symptoms plus long-term complications particularly of PPI therapy should be considered to ensure that optimal treatment is delivered.
Pain site and radiation and the effect of various foods were studied prospectively in a consecutive series of patients with chronic upper abdominal pain. Patients followed for less than one year were excluded unless peptic ulcer or abdominal malignancy had been diagnosed or laparotomy had been carried out. A total of 632 patients were eligible for the first study and 431 for the second. Gastric ulcer pain was more likely to be left hypochondrial (17%) compared with pain from duodenal ulcer (4%) or from all other conditions (5%). It was less likely to be epigastric (54%) compared with duodenal ulcer pain (75%). Oesophageal pain was more likely to be both retrosternal and epigastric (25%) compared with non-oesophageal pain (2%). Radiation to the back was more common in peptic ulcer (31%) and biliary pain (35%) compared with functional pain (20%). Pain precipitation by fatty foods was commoner in biliary disease (40%) than in duodenal ulcer (11%), peptic ulcer (9%), or non-ulcer dyspepsia (19%). Orange, alcohol, and coffee precipitated pain more frequently in duodenal ulcer (41%, 50%, and 43% respectively) than in biliary disease (17%, 0%, and 14% respectively). Chilli precipitated pain in one quarter to one half of subjects regardless of diagnosis. Approximately one tenth of all subjects avoided chilli, curry, coffee, and tea because of medical or other advice.
Gastroesophageal reflux disease (GERD) has been an area of active research in the Asia-Pacific region in the recent years. This article outlines some of the interesting research findings. It comprises three parts. The first part dealt with recent data on the changing epidemiology of GERD in Asia. The second part summarized published studies on the relationship between GERD and Helicobacter pylori, relevant to the Asia-Pacific region. The last part discussed some of the recent advances in the treatment of GERD.
Lifestyle modifications are first-line therapy for patients with gastroesophageal reflux disease (GERD). We applied an evidence-based approach to determine the efficacy of lifestyle measures for GERD management. We used PubMed and Ovid to perform a search of the literature published between 1975 and 2004 using the key words heartburn, GERD, smoking, alcohol, obesity, weight loss, caffeine or coffee, citrus, chocolate, spicy food, head of bed elevation, and late-evening meal. Each study was reviewed by 2 reviewers who assigned one of the following ratings: evidence A, randomized clinical trials; evidence B, cohort or case-control studies; evidence C, case reports or flawed clinical trials; evidence D, investigator experience; or evidence E, insufficient information. We screened 2039 studies and identified 100 that were relevant. Only 16 clinical trials examined the impact on GERD (by change in symptoms, esophageal pH variables, or lower esophageal sphincter pressure) of the lifestyle measure. Although there was physiologic evidence that exposure to tobacco, alcohol, chocolate, and high-fat meals decreases lower esophageal sphincter pressure, there was no published evidence of the efficacy of dietary measures. Neither tobacco nor alcohol cessation was associated with improvement in esophageal pH profiles or symptoms (evidence B). Head of bed elevation and left lateral decubitus position improved the overall time that the esophageal pH was less than 4.0 (evidence B). Weight loss improved pH profiles and symptoms (evidence B). Weight loss and head of bed elevation are effective lifestyle interventions for GERD. There is no evidence supporting an improvement in GERD measures after cessation of tobacco, alcohol, or other dietary interventions.
Although the ingestion of chilli has been associated with gastroesophageal reflux (GER) symptoms, there are no studies that have explored the effect of a chronic ingestion of different kinds of chilli with a variable content of capsaicin as a cause of GER.
The effect of chilli on esophageal 24-hour pH monitoring was studied in 12 healthy subjects without GER symptoms before and after of ingestion one of two kinds of chilli. Patients were randomized to ingest 3 g daily of cascabel chilli (Capsicum annum coraciforme containing 880 ppm of capsaicin) or ancho chilli (Capsicum annum grossum containing 488 ppm of capsaicin).
After chilli ingestion, the Johnson De Meester Index (JDI) increased significantly [basal: 7 (1-14), after chilli: 13 (2-69), p = 0.0047]. When considering both kinds of chilli separately, the JDI varied, although nonsignificantly, with the ancho chilli [basal: 3 (1-8), after chilli: 10 (2-69), p = 0.11], and significantly with the cascabel chilli [basal: 10 (5-14), after chilli: 18 (2-44), p = 0.028].
Our results suggest that the chronic ingestion of chilli induces GER, and that the magnitude of the induced reflux seems to be related to the kind of chilli.
Objective: Data on the epidemiology of chronic gastrointestinal symptoms in the East are limited. The aims of this study were to estimate the prevalence of chronic gastrointestinal symptoms in Singapore and to determine whether ethnic differences in the prevalence of these symptoms exist. Methods: A cross-sectional survey, using a reliable and valid questionnaire, was carried out in a race-stratified random sample of residents aged 21–95 yr (mean ± SD, 40 ± 1 yr) in a Singaporean town; 93% responded (n = 696). Results: The ethnic-adjusted prevalence of chronic abdominal pain, frequent dyspepsia, irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent reflux were 5.7% (95% confidence interval [CI], 3.3–8.1), 7.9% (95% CI, 5.0–10.8), 2.3% (95% CI, 0.8–3.9), 3.9% (95% CI, 1.9–5.9), 4.5% (95% CI, 2.3–6.7), and 1.6% (95% CI, 0.6–2.6), respectively. There were no ethnic differences in the prevalence of any of these symptom categories except for reflux-type symptoms, which were more common among Indians (7.5%; 95% CI, 4.4–11.7) than Chinese (0.8%; 95% CI, 0.1–3.0) or Malays (3.0%; 95% CI, 1.2–6.1). Conclusion: The prevalence of all types of chronic gastrointestinal symptoms in the general population of Singapore was low compared with those in the West. Chronic gastrointestinal symptoms were equally prevalent in the three major ethnic groups except for reflux-type symptoms, which were more common among Indians than Chinese or Malays.
We aimed to determine whether healthy volunteers with normal pH monitoring study results experienced heartburn or discomfort
during an esophageal acid perfusion test. We performed an esophageal acid perfusion test, followed by ambulatory esophageal
pH monitoring, in 15 healthy and asymptomatic volunteers (aged 19 to 34 years). The results of the acid perfusion test were
correlated with those of the pH monitoring. Three subjects (20%) reported chest discomfort during acid perfusion. The pH data
in all subjects were within our laboratory reference ranges; the median (range) percent total time at pH < 4 being 1.7 (0.2–4.0)%
[laboratory reference, median (range), 3.0 (0.2–4.0)%]. We concluded that direct infusion of acid onto the distal esophagus
can produce discomfort akin to that of gastroesophageal reflux disease in asymptomatic adult volunteers, even in the absence
of excessive esophageal acid exposure.
Chili ingestion produces gastrointestinal symptoms in many subjects. Some of these symptoms, such as heartburn, might well arise from the esophagus, but the pathogenesis is unknown. We studied the effects of chili ingestion on esophageal motility in 16 healthy volunteers and correlated these with the production of chili-induced upper gastrointestinal symptoms. We also studied the effects of chili instillation into the esophagus in 15 of the subjects to determine whether typical symptoms were produced. There were no changes in esophageal manometric parameters in all 16 subjects after the ingestion of a chili suspension (5 g chili powder in 100 ml water), although half of them reported one or more symptoms. Direct instillation of the same chili suspension into the lower esophagus produced typical symptoms in all 15 volunteers tested. Chili-induced upper gastrointestinal symptoms were not accompanied by changes in esophageal motility. The esophageal mucosa itself was sensitive to chili, suggesting that at least some of the upper gastrointestinal symptoms produced by chili are mediated by direct stimulation of chili-sensitive afferent nerve endings in the esophageal mucosa.
Data on the epidemiology of chronic gastrointestinal symptoms in the East are limited. The aims of this study were to estimate the prevalence of chronic gastrointestinal symptoms in Singapore and to determine whether ethnic differences in the prevalence of these symptoms exist.
A cross-sectional survey, using a reliable and valid questionnaire, was carried out in a race-stratified random sample of residents aged 21-95 yr (mean+/-SD, 40+/-1 yr) in a Singaporean town; 93% responded (n=696).
The ethnic-adjusted prevalence of chronic abdominal pain, frequent dyspepsia, irritable bowel syndrome, chronic constipation, chronic diarrhea, and frequent reflux were 5.7% (95% confidence interval [CI], 3.3-8.1), 7.9% (95% CI, 5.0-10.8), 2.3% (95% CI, 0.8-3.9), 3.9% (95% CI, 1.9-5.9), 4.5% (95% CI, 2.3-6.7), and 1.6% (95% CI, 0.6-2.6), respectively. There were no ethnic differences in the prevalence of any of these symptom categories except for reflux-type symptoms, which were more common among Indians (7.5%; 95% CI, 4.4-11.7) than Chinese (0.8%; 95% CI, 0.1-3.0) or Malays (3.0%; 95% CI, 1.26.1).
The prevalence of all types of chronic gastrointestinal symptoms in the general population of Singapore was low compared with those in the West. Chronic gastrointestinal symptoms were equally prevalent in the three major ethnic groups except for reflux-type symptoms, which were more common among Indians than Chinese or Malays.
Data on prolonged ambulatory oesophageal pH and pressure monitoring in normal subjects in the East are limited. This study aimed to define the normal characteristics of ambulatory oesophageal pH and motility among healthy adults in Singapore.
Prolonged ambulatory oesophageal pH and pressure recording was performed on 10 healthy volunteers using a one-channel pH probe, a two channel pressure probe, a portable digital data recorder and a computerised data analysis system. The median (range) number of episodes with pH < 4 and the percentage of total time with pH < 4 were 24% (4%-56%) and 3.0% (0.2%-4.0%) respectively. They were greater in the upright than supine positions.
The median percentages of peristaltic and simultaneous contractions were 65.8%-80.5% and 10.6%-12.7% respectively. The frequency, amplitude and duration of peristaltic contractions were greater during mealtimes than between meals in the upright position.
This study provides the first data on prolonged ambulatory oesophageal pH and manometry in healthy Singaporean adults.