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Biomedical subjects

G R Locke

Publications and source records attributed to G R Locke.

At least 19 recordsLinked to original sources

Prevalence and management of abdominal cramping and pain: a multinational survey.

BACKGROUND: Though functional gastrointestinal complaints are recognised as being common throughout the world, there have been few comparative studies of prevalence. AIM: To compare the prevalence and management of abdominal cramping/pain in nine countries. METHODS: In a two-stage community survey, approximately 1000 subjects were interviewed in each of nine countries to establish the demographics of individuals with abdominal cramping/pain (stage 1) followed by market research-driven interviews with >or=200 sufferers per country (stage 2). RESULTS: 9042 subjects were interviewed in stage 1. Mexico (46%) and Brazil (43%) had the highest prevalence of abdominal cramping/pain; Japan the lowest (10%). Abdominal cramping/pain was more common in women (12-55%) than in men (7-38%). About 1717 subjects participated in stage 2; 65% were women and the average age at symptom onset was 29 years. The frequency of episodes differed between countries, being highest in the US (61% suffered at least once in a week). Sufferers in the US and Latin America reported a higher usage of medications (around 90%) than those in Europe (around 72%). In most countries over-the-counter drugs were principally used. Antispasmodic drugs were most popular in Latin America and Italy, antacids in Germany and the UK. Drug therapy decreased the duration of episodes (by up to 81% in Brazil). CONCLUSIONS: The community prevalence, severity, healthcare seeking and medication usage related to abdominal cramping/pain are high overall, but vary considerably between countries.

Abdominal Pain↗

Alternating bowel pattern: what do people mean?

BACKGROUND: With the introduction of new therapies, the subgrouping of patients based on bowel pattern has become important. However, the appropriate definition of an alternating bowel pattern remains unclear. AIM: To determine if specific symptoms are reported by people with an alternating bowel pattern. METHODS: Using the Rochester Epidemiology Project, a series of population-based surveys were undertaken in which valid self-report gastrointestinal symptom questionnaires were mailed to 4029 randomly selected members of the community. One question asked was 'How would you describe your usual bowel pattern in the last year'? RESULTS: 3022 subjects (74%) provided questionnaire data and 2718 were eligible for this analysis, the mean age was 57 years, with a range of 20-98 years (median = 61). Of these, 9.2%, 2.5% and 7.6% reported their usual bowel pattern as being constipated, diarrhoea, or alternating respectively. At least 50% of those reporting alternating bowel pattern reported incomplete evacuation (63%), urgency (57%), straining (55%) and loose stool (50%). The proportion of alternators reporting each individual symptom was between that of diarrhoea and constipation except for mucus and incomplete evacuation; however, no symptom was unique to alternators. CONCLUSION: People who self-report an alternating bowel pattern appear to represent a blend of constipation and diarrhoea symptoms, rather than a distinct subgroup.

Adult↗

Predictors of the placebo response in functional dyspepsia.

BACKGROUND: Trials in functional dyspepsia report placebo response rates of 30% to 40%. AIM: We aimed to identify predictors of the placebo response. METHODS: Patients from primary, secondary and tertiary practices with functional dyspepsia defined by Rome II criteria were enrolled into one of four clinical trials; 220 patients were randomized to receive placebo. Scintigraphic assessment of gastric emptying at baseline was repeated at the end of the treatment in those with delayed emptying. After a 2 week run-in period, patients were followed for 8 weeks on placebo. Response was assessed on a weekly basis and a responder was defined as satisfactory relief of meal-related symptoms on at least 50% of weeks. RESULTS: The mean age was 44 years (range 18-82) and 74% were female; 76 (35%) were placebo responders. The predominant symptom was an unstable measure over the trial. Independent predictors of a lower placebo response were lower body mass index and a more consistent predominant symptom pattern (both P < 0.05). No association was seen with age, gender, centre type, baseline symptom score, baseline or change in gastric emptying, or baseline quality of life. CONCLUSION: In functional dyspepsia, a consistent predominant symptom pattern and lower body mass index may be associated with a lower placebo response rate.

Adolescent↗

Supraesophageal reflux: validation of a symptom questionnaire.

OBJECTIVE: To develop and validate a questionnaire for supraesophageal manifestations of reflux (SER) that will facilitate its study in clinical and research settings. STUDY DESIGN: The Supraesophageal Reflux Questionnaire (SERQ) and previously validated Reflux Symptom Index (RSI) were subjected to multiple types of validity testing, including content validity, concurrent validity, reproducibility, and predictive validity. RESULTS: The concurrent validity and reproducibility of both instruments was good to excellent for most items tested. The predictive validity of the SERQ was superior to the RSI when it included the covariates of history of sinusitis, use of over-the-counter antacid medications, age, gender, and body mass index. CONCLUSIONS: The SERQ will serve as both a useful clinical and research tool by offering not only SER symptom information, like the RSI, but also information about the patient's medical history and medication usage that will facilitate use of the SERQ in research protocols. EBM RATING: B-2b.

Antacids↗

Use of antisecretory drugs among consumers of non-steroidal anti-inflammatory drugs in the general population.

BACKGROUND: Overall success of prophylactic strategies against non-steroidal anti-inflammatory drug (NSAID) complications depends on the use of gastroprotective drugs. AIM: We examined the use of antisecretory drugs in NSAID users in the general population of Spain. PARTICIPANTS AND METHODS: In 2002, a phone interview was conducted with 2500 persons representative of the general population of Spain. Using a validated questionnaire, we asked about the use of NSAID, aspirin and antisecretory drugs, and history of digestive diseases. We estimated the use of antisecretory drugs in NSAID users, according to risk factors for gastrointestinal (GI) lesions associated with NSAID. RESULTS: In total, 425 persons [17.0% (95% CI 15.5-18.5%)] were NSAID users. Of them, 69 persons (16.2%; 95% CI 12.7-19.7%) used antisecretory drugs [proton pump inhibitor (PPI) 11.8% and H2-blocker 4.9%]. Forty-four of the 224 NSAID users (19.6%) with one risk factor for GI lesions were antisecretory drug users (PPI 16%; H2-blocker 4%), compared with 24 of the 197 NSAID users (12.7%) without risk factors (PPI 6.6%; H2-blocker 6.1%). NSAID users with risk factors for GI lesions but without upper GI (UGI) symptoms did not consume more antisecretory drugs than equivalent non-NSAID users (12.9% vs. 10.7%). CONCLUSION: Current strategies to prevent GI lesions in NSAID users are not effective from a population perspective, especially in subjects without UGI symptoms.

Adult↗

Influence of alcohol consumption on IBS and dyspepsia.

The role of alcohol use in irritable bowel syndrome (IBS) and dyspepsia is not well understood. We hypothesised that people with psychological distress who drink no alcohol, or excess alcohol, are at increased risk of having IBS or dyspepsia. Valid gastrointestinal (GI) symptom surveys were mailed to randomly selected cohorts of community residents. Associations between IBS, dyspepsia and abdominal pain and alcohol use were assessed using logistic regression adjusted for a Somatic Symptom Checklist score (SSC). A total of 4390 (80%) responded; of these, 10.5% reported IBS, 2% dyspepsia and 22% abdominal pain. Alcohol consumption >7 drinks week(-1) was associated with a greater odds for dyspepsia (OR 2.3; 95% CI:1.1-5.0) and frequent abdominal pain (OR 1.5; 95% CI: 1.1-2.0) but not IBS. However, significant interactions among gender, alcohol use and SSC scores were detected (P < 0.005). In females with a low SSC score, consuming alcohol > or =7 drinks week(-1) increased the odds of IBS compared to drinking alcohol moderately. Alcohol consumption was associated with dyspepsia and abdominal pain. A relationship with IBS was identified when interactions with somatization and gender were appropriately considered. Whether these associations are due to the effects of alcohol on the gut, or a common central mechanism remains to be determined.

Abdominal Pain↗

Relationship between upper gastrointestinal symptoms and changes in body weight in a population-based cohort.

Obesity has been associated with increased reporting of gastrointestinal (GI) symptoms, but whether weight gain or loss causes symptoms is unclear. We studied the association between changes in body weight and changes in upper GI symptoms. Prospective cohort study on random samples of Olmsted County, MN residents. Distinct upper GI symptom complexes [gastro-oesophageal reflux disease (GERD), chest pain, dyspepsia- pain predominant, dyspepsia-dysmotility] were defined. Subjects with persistent, new-onset or disappearing symptoms were identified as cases, subjects with no reported symptoms in any of the surveys served as controls. Associations were studied in a logistic regression model, using age, gender, baseline Body Mass Index and somatic symptom score as covariates. Participants for whom baseline and follow-up data were available (n = 637) had a median time between surveys of 10.5 years. Baseline body weight was associated with GERD, chest pain and dyspepsia-pain predominant symptom complexes. An increase in body weight >10 lb between surveys was associated with new onset of dyspepsia-dysmotility (OR 5.57, 95% CI 1.91, 16.2). No association was found between weight loss >10 lb and the studied symptom complexes. Moderate body weight increases and decreases are generally not associated with upper GI symptom changes over time in the general population.

Age Factors↗

Functional dyspepsia, delayed gastric emptying, and impaired quality of life.

BACKGROUND: It remains controversial as to whether delayed gastric emptying in functional dyspepsia is associated with a specific symptom pattern, and it is unknown if gastric emptying in functional dyspepsia is a driver of impaired health related quality of life (HRQOL). We aimed to evaluate the relationship between functional dyspepsia symptoms, gastric emptying, and HRQOL. METHODS: US patients (n=864; mean age 44 years (range 18-82); 74% female) with functional dyspepsia, as defined by Rome II criteria, were enrolled into one of four clinical trials. All patients had a baseline scintigraphic assessment of gastric emptying of an egg substitute meal, and the trials were stratified on this assessment. Delayed gastric emptying was defined as having at least 6.3% residual volume at four hours. A total of 290 (34%) patients had delayed gastric emptying. HRQOL was assessed by the SF 36 and Nepean dyspepsia index (NDI). RESULTS: Postprandial fullness was independently associated with delayed gastric emptying but the association was weak (odds ratio (OR) 1.98 (95% confidence interval (CI) 1.02, 3.86); p=0.04). No independent association was seen with epigastric pain, early satiety, nausea, or bloating. Mean SF 36 physical composite score (PCS) was 42.3 (95% CI 41.6, 43.0) and the mean SF 36 mental composite score (MCS) was 46.8 (95% CI 46.0, 47.5); both mean scores were significantly lower than age and sex adjusted national norms of 50 (p<.0001). Female sex, increasing age, and higher symptom scores for fullness, epigastric pain, and nausea were each independently associated with decreased PCS scores (all p<0.05). Higher baseline nausea symptom score, lower gastric emptying rates at one hour, and lower body mass index were associated with decreased MCS (all p<0.05). Female sex, epigastric pain, and nausea, but not gastric emptying, were associated with an impaired score on the NDI. However, the magnitude of the significant associations were all small. CONCLUSIONS: In patients with functional dyspepsia selected for a clinical trial programme, gastric emptying did not usefully stratify them symptomatically. Quality of life of patients with functional dyspepsia enrolled in this clinical trial programme was significantly impaired but this was not explained by delayed gastric emptying.

Adolescent↗

Risk factors for non-cardiac chest pain in the community.

BACKGROUND: Non-cardiac chest pain is a common and expensive condition. Risk factors for non-cardiac chest pain are poorly understood and lack description in the USA community. AIM: To explore risk factors and health-seeking behaviour in non-cardiac chest pain in a USA community. METHODS: Olmsted County, MN subjects who reported at least monthly or severe chest pain in response to a validated questionnaire were compared with controls. All the Mayo Clinic medical records were reviewed; those with cardiac disease or relevant organic conditions were excluded. RESULTS: Of 2118 eligible subjects, 1524 (72%) returned a questionnaire, 389 subjects (26%) reported any chest pain and 186 (12.2%) at least monthly or severe chest pain. Of these, 62 were excluded for a cardiac diagnosis or another organic cause. Thus, 124 subjects (9.1%, 95% CI: 7.6-10.8%) reported at least monthly or severe non-cardiac chest pain, of which 65 (52.4%) had frequent reflux symptoms. Independent risk factors for non-cardiac chest pain were obesity (OR 3.0, 95% CI: 1.64-5.50), family history of reflux (OR 2.8, 95% CI: 1.73-4.32), previous cigarette use (OR 2.0, 95% CI: 1.27-3.18), aspirin use (OR 1.5, 95% CI: 1.00-2.31) and use of antiarthritis medicines (OR 2.0, 95% CI: 1.27-3.16). Compared with subjects with non-cardiac chest pain and associated gastro-oesophageal reflux symptoms, subjects with non-cardiac chest pain without associated gastro-oesophageal reflux symptoms were less likely to have a family history of reflux, more likely to be younger, and less likely to be obese. Compared with controls, subjects with non-cardiac chest pain without gastro-oesophageal reflux symptoms were younger (OR 0.97, 95% CI: 0.95-0.99), reported higher somatic symptom scores (OR 1.1, 95% CI: 1.08-1.73) and were more likely to be obese (OR 2.6, 95% CI: 1.15-5.93). CONCLUSIONS: Recurrent or severe non-cardiac chest pain is common in the community. Half of the people with significant non-cardiac chest pain have frequent reflux symptoms, thus, risk factors for non-cardiac chest pain are similar to risk factors for gastro-oesophageal reflux disease. People with non-cardiac chest pain without reflux symptoms have a slightly different risk factor profile.

Adult↗

Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact.

BACKGROUND: The impact of irritable bowel syndrome, a gastrointestinal motility disorder, is underestimated and poorly quantified, as clinicians may see only a minority of sufferers. AIM: To determine the prevalence, symptom patterns and impact of irritable bowel syndrome in the US. METHODS: This two-phase community survey used quota sampling and random-digit telephone dialing (screening interview) to identify individuals with medically diagnosed irritable bowel syndrome or individuals not formally diagnosed, but fulfilling irritable bowel syndrome diagnostic criteria (Manning, Rome I or II). Information on irritable bowel syndrome symptoms, general health status, lifestyle and impact of symptoms on individuals' lives was collected using in-depth follow-up interviews. Data were also collected for healthy controls identified in the screening interviews. RESULTS: The total prevalence of irritable bowel syndrome in 5009 screening interviews was 14.1% (medically diagnosed: 3.3%; undiagnosed, but meeting irritable bowel syndrome criteria: 10.8%). Abdominal pain/discomfort was the most common symptom prompting consultation. Most sufferers (74% medically diagnosed; 63% undiagnosed) reported alternating constipation and diarrhoea. Previously diagnosed gastrointestinal disorders occurred more often in sufferers than non-sufferers. Irritable bowel syndrome sufferers had more days off work (6.4 vs. 3.0) and days in bed, and reduced activities to a greater extent than non-sufferers. CONCLUSIONS: Most (76.6%) irritable bowel syndrome sufferers in the US are undiagnosed. Irritable bowel syndrome has a substantial impact on sufferers' well-being and health, with considerable socioeconomic consequences.

Activities of Daily Living↗

Overlap of gastrointestinal symptom complexes in a US community.

BACKGROUND: Although the Rome criteria define a number of individual functional gastrointestinal disorders, people may have symptoms of multiple disorders at the same time. In addition, therapies may be effective in subsets of people with specific disorders, yet at the same time help people with multiple disorders. AIM: To estimate the prevalence of combinations of gastrointestional (GI) symptom complexes. METHODS: A valid self report questionnaire which records GI symptoms was mailed to an age- and gender-stratified random sample of Olmsted County, MN residents aged 30-64 years. Standard definitions were used to identify people with gastro-oesophageal reflux, dyspepsia, irritable bowel syndrome (IBS), constipation and diarrhoea. The prevalence of people meeting multiple symptom complexes was estimated. Specifically, combinations of dyspepsia, IBS and constipation were compared to dyspepsia, IBS and diarrhoea. RESULTS: A total of 657 (69%) of 943 eligible subjects responded; 643 provided data for each of the necessary symptom questions. Each two-way combination of symptom group was present in between 4 and 9% of the population; each three-way combination was present in 1-4% of the population. The overlap between dyspepsia, IBS and constipation was similar to dyspepsia, IBS and diarrhoea, except body mass index was higher in the diarrhoea overlap group (P = 0.03). CONCLUSION: Symptom complex overlap is common in the community; for each condition, the majority of sufferers reported an additional symptom complex. This overlap of symptoms challenges the current paradigm that functional GI disorders represent multiple discreet entities.

Adult↗

Dyspepsia management in primary care: a management trial.

The aim was to evaluate the outcomes associated with four initial management strategies in new patients presenting to primary care physicians with dyspepsia. Patients with new symptoms (no alarm features) were randomised to empirical therapy (n = 11), Helicobacter pylori (HP) serology (n = 8), HP breath testing (n = 11) or oesophagogastroduodenoscopy (n = 13). Dyspepsia and health-related quality of life were assessed using standardised questionnaires at entry, 6 and 24 weeks post-trial enrollment. Outcomes were assessed by structured telephone interview every 6 weeks. In the initial HP testing arms, 21% were positive; 27% in the oesophagogastroduodenoscopy arm had inflammatory changes without ulcers at baseline. The majority (67%) received over the counter medication after initial management. Symptom-free status was similarly common in all groups (p = 0.49); only 20% pursued further evaluation. Total billed charges were higher in the oesophagogastroduodenoscopy group (US 2077 dollars) vs. empirical therapy (US 512 dollars), despite excluding the charge for initial oesophagogastroduodenoscopy, but overall, no effects on total medical charges were detected (p = 0.10). Regardless of initial management, most patients remained symptomatic, yet did not return for health care visits or undergo endoscopies. The cost of upfront endoscopy may not be the best choice for patients presenting with new dyspepsia.

Breath Tests↗

Relationship between body mass index, diet, exercise and gastro-oesophageal reflux symptoms in a community.

BACKGROUND: Body mass index (BMI) is a risk factor for gastro-oesophageal reflux but may simply be explained by diet and lifestyle. AIM: We aimed to determine the contribution of BMI, diet and exercise to GER. METHODS: Community subjects (n = 211, mean age = 36 years, 43% males) completed validated questionnaires on gastro-oesophageal reflux, energy expenditure (Harvard Alumni Activity Survey), dietary intake (Harvard Food Frequency Questionnaire) and measures of personality and life event stress. Diet, exercise, BMI and other potential risk factors for reflux were analysed using logistic regression analyses. RESULTS: The overall mean (+/- s.d.) BMI was 26.6 (+/- 5.7); 79 (37%) reported infrequent (< weekly) reflux and 16 (8%) reported frequent (> or = weekly) reflux. The median caloric intake was 2097 cal/day and the median daily energy expenditure was 1753 cal/day. Among those with BMI > 25, 10% reported frequent reflux compared to 4% of those with BMI < or = 25. In a model which included age, sex and Symptom Checklist-90 somatisation T-score, BMI was associated with reflux (OR per 5 units = 1.9, 95% CI: 1.2, 3.0). In models which included diet and exercise variables, BMI but not diet or exercise was associated with reflux. CONCLUSION: BMI may be associated with symptomatic gastro-oesophageal reflux independent of diet and exercise.

Adult↗

A new questionnaire for constipation and faecal incontinence.

BACKGROUND: The prevalence, severity and risk factors of faecal incontinence in women in the community are incompletely characterized. AIM: To develop and validate a self-report questionnaire (faecal incontinence and constipation assessment) to address these issues. METHOD: Eighty-three women completed the instrument; 20 randomly selected patients answered the faecal incontinence and constipation assessment again 6 weeks later. A gastroenterologist also completed the faecal incontinence and constipation assessment in all 83 subjects after a detailed clinical assessment. Concurrent validity was evaluated by comparing the patient's self-report to a doctor interview for every question. Reproducibility was evaluated by a test-retest approach for every question. The severity of faecal incontinence was rated by incorporating the frequency and type of faecal incontinence, rectal urgency and use of sanitary devices. RESULTS: The questionnaire was well-understood. Reproducibility [median kappa statistic, 0.80 (interquartile range: 0.66-0.90)]; and concurrent validity [0.59 (0.47-0.67)] were acceptable. For the index question on faecal incontinence, the kappa for reproducibility and concurrent validity was 0.90 and 0.95, respectively. The faecal incontinence severity score was also valid (kappa = 0.5). CONCLUSION: The faecal incontinence and constipation assessment has excellent reproducibility and reasonable validity for assessing the presence, risk factors and severity of faecal incontinence and associated bowel disorders in women when compared against clinical assessment.

Adult↗

Incidence of a clinical diagnosis of the irritable bowel syndrome in a United States population.

BACKGROUND: The incidence of irritable bowel syndrome is uncertain. We aimed to determine the incidence of clinically diagnosed irritable bowel syndrome in the community. METHODS: Using the Rochester Epidemiology Project, all diagnoses of irritable bowel syndrome made among adult residents of Olmsted County, Minnesota, over a 3-year period were identified. The complete medical records of a random sample of the potential subjects were reviewed for the 10 years prior to the irritable bowel syndrome diagnosis and any patient who had received a previous diagnosis of irritable bowel syndrome was excluded (prevalent cases). RESULTS: The diagnostic index listed 1245 possible irritable bowel syndrome patients; 416 patient charts were reviewed and, of these, 149 were physician diagnosed incident cases of irritable bowel syndrome. The age- and sex-adjusted incidence rate was 196 per 100,000 person-years and increased with age (P = 0.006). The age-adjusted annual incidence per 100,000 in women was higher than in men: 238 vs. 141 (ratio 3:2; P = 0.005). The overall symptom frequency at the time of diagnosis was abdominal pain (73%), diarrhoea (41%) and constipation (16%). CONCLUSIONS: The incidence of a clinical diagnosis of irritable bowel syndrome in adults was estimated to be two per 1000 per year, increased with age and was higher in women than men. As many people with irritable bowel syndrome do not seek care, the true incidence of irritable bowel syndrome is likely to be higher.

Adolescent↗

Impact of functional gastrointestinal disorders on health-related quality of life: a population-based case-control study.

BACKGROUND: The health-related quality of life is impaired in patients with functional gastrointestinal disorders seen in referral centres. AIM: To determine whether the health-related quality of life is impaired in subjects with functional disorders in the community and whether any differences can be explained by psychological co-morbidity. METHODS: In a population-based, nested, case-control study, subjects reporting symptoms of either dyspepsia or irritable bowel syndrome and healthy controls were interviewed and completed a battery of psychological measures plus a validated, generic, health-related quality of life measure (Medical Outcomes Study 36-item short form health survey, SF-36). The association between irritable bowel syndrome and dyspepsia and the physical and mental composite scores of SF-36 were assessed with and without adjustment for psychological state. RESULTS: One hundred and twelve cases (30 dyspepsia, 39 irritable bowel syndrome, 32 dyspepsia and irritable bowel syndrome and 11 gastrointestinal symptoms but not dyspepsia or irritable bowel syndrome) and 110 controls were enrolled. In the unadjusted linear regression models, irritable bowel syndrome (but not dyspepsia) was negatively associated with the physical composite score (P < 0.05); in an adjusted model, the association between the physical health-related quality of life and irritable bowel syndrome was explained by the Symptom Checklist-90 somatization score alone. In unadjusted models, irritable bowel syndrome and dyspepsia were each negatively associated with the mental composite score (P < 0.05). The association between the mental health-related quality of life and dyspepsia remained after adjusting for psychological covariates, but the association between this and irritable bowel syndrome was not significant after adjustment. CONCLUSIONS: In the community, health-related quality of life is impaired in subjects with irritable bowel syndrome and dyspepsia; however, much of this association can be explained by psychological factors.

Adult↗

Symptoms of gastro-oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population.

AIM: To measure the prevalence of gastro-oesophageal reflux symptoms and to identify associated factors in a representative sample of the Spanish population. METHODS: A telephone survey of 2500 subjects was performed using a validated questionnaire. The association of gastro-oesophageal reflux symptoms (defined as the presence of heartburn or acid regurgitation) and their clinical characteristics with potential risk factors was summarized using the odds ratios (OR) obtained by multiple logistic regression. RESULTS: The response rate was 71.2%. The annual prevalence of gastro-oesophageal reflux symptoms was 31.6% [95% confidence interval (CI), 29.8-33.4] and the weekly prevalence was 9.8% (95% CI, 8.6-10.9). Gastro-oesophageal reflux symptoms were associated with excess weight (OR, 1.53; 95% CI, 1.23-1.92), obesity (OR, 1.74; 95% CI, 1.30-2.32), the psychosomatic symptom score (OR, 2.98; 95% CI, 2.41-3.67) and the presence of gastro-oesophageal reflux symptoms in a direct family member (OR, 1.61; 95% CI, 1.17-2.23). Gastro-oesophageal reflux symptoms of > or =10 years' duration were more frequent in obese subjects (OR, 1.92; 95% CI, 1.14-3.22) and those with a direct family member with gastro-oesophageal reflux symptoms (OR, 2.42; 95% CI, 1.44-4.06). Factors associated with gastro-oesophageal reflux symptoms of < or =1 year duration were a spouse with gastro-oesophageal reflux symptoms (OR, 2.33; 95% CI, 1.39-3.9) and the consumption of 1-5 aspirins/week (OR, 1.70; 95% CI, 1.01-2.86). CONCLUSIONS: The prevalence of frequent gastro-oesophageal reflux symptoms in Spain is lower than that observed in other Western populations. The psychosomatic symptom score is the factor most strongly associated with gastro-oesophageal reflux symptoms. Long-term gastro-oesophageal reflux symptoms are associated with certain genetic factors (obesity, family history of gastro-oesophageal reflux symptoms), whereas short-term gastro-oesophageal reflux symptoms are associated with factors of probable environmental nature.

Adult↗