title: The prevalence of gastro-oesophageal reflux disease based on non-specific symptoms in institutionalized, intellectually disabled individuals.
abstract: OBJECTIVE
  The prevalence of gastro-oesophageal reflux disease (GORD) in randomly selected, institutionalized, intellectually disabled individuals (IQ < 50) in The Netherlands is high.
  
  
  METHODS
  In this study we investigated the prevalence of GORD and reflux oesophagitis (RO) in intellectually disabled individuals specifically selected for symptoms such as: behavioural difficulties such as automutilation, food refusal, fear and restlessness, vomiting, regurgitation and rumination. Predisposing factors were also evaluated.
  
  
  METHODS
  One hundred and ten individuals from one institute underwent a 24-h oesophageal pH test and were scored for predisposing factors and non-specific reflux symptoms. A pathological pH test was defined as a pH lower than 4 more than 4.5% of the measured time. Subjects with a pathological pH test (patients) were compared to those with a normal pH test (controls).
  
  
  RESULTS
  In seven cases (6.4%) the test failed for technical reasons. In 57 (55.3%) cases a pathological pH test was found. RO was diagnosed in 33 (64.7%) patients. The use of anticonvulsant drugs and cerebral palsy appeared to be predisposing factors, while the non-specific reflux symptoms did not discriminate for GORD.
  
  
  CONCLUSIONS
  The prevalence of GORD was equal in a randomly selected group of intellectually disabled individuals, and in this group, specifically selected on account of possible reflux symptoms. This study confirms that in this particular group, it is nearly impossible to discriminate for the diagnosis of GORD on non-specific reflux symptoms only. However, GORD may be suspected where there are certain predisposing factors, particularly cerebral palsy and use of anticonvulsant drugs.)
authors.affiliation: Bartiméus, Institute for Intellectually Disabled, Zeist, The Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: Böhmer
authors.forename: E C
authors.initials: EC
authors.lastname: Klinkenberg-Knol
authors.forename: R C
authors.initials: RC
authors.lastname: Niezen-de Boer
authors.forename: S G
authors.initials: SG
authors.lastname: Meuwissen
mesh_terms: D000328:Adult; D015984:Causality; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007326:Institutionalization / Q000706:statistics & numerical data*; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D015995:Prevalence