title: High incidence of newly-developed gastroesophageal reflux disease in the Japanese community: a 6-year follow-up study.
abstract: OBJECTIVE
  We conducted a community-based study to assess the incidence of newly-developed gastroesophageal reflux disease (GERD). We also analyzed the risk factors of GERD occurrence.
  
  
  METHODS
  A total of 322 patients without acid suppression therapy (135 men, mean age: 59.8 years), who lived in the Japanese community, took a QUEST questionnaire (a self-administered questionnaire for the screening of GERD) in 1998. Blood samples were taken for the measurement of an anti-Helicobacter pylori antibody and pepsinogen (PG) I/II to assess the grade of gastric atrophy. Of these patients, 289 scored less than six points and were diagnosed as non-GERD. Two-hundred-and-forty-one patients (95 men, mean age: 67.0 years) took the QUEST questionnaire again in 2004 (after 6 years). The incidence of newly-developed GERD was analyzed. These patients were categorized into three groups based on their initial PG I/II (group A: less than three, group B: three to six, and group C: more than six). The risk factors of GERD occurrence were evaluated.
  
  
  RESULTS
  Of the 241 non-GERD patients, 37 patients (15.4%) developed GERD after 6 years. The incidence of newly-developed GERD in group C was significantly higher than both groups A and B (group A: 3.8% [three of 79], group B: 11.8% (11/93), group C: 33.3% (26/69), P < 0.01, respectively). The prevalence of H. pylori negativity, constipation, and medication of Ca antagonists in newly-developed GERD were significantly higher than in those who did not develop GERD. [Correction added after online publication on 1 July 2007: the preceding sentence has replaced one that read 'The prevalence of H. pylori negativity, constipation, and medication of Ca antagonists in newly-developed GERD were significantly higher than in those who did develop GERD.']
  
  
  CONCLUSIONS
  The incidence of newly-developed GERD in the Japanese community was 16.5% for 6 years. The incidence of newly-developed GERD patients who scored a PG I/II over six was significantly higher than those who scored lower. H. pylori negativity, constipation, and medication of Ca antagonists might be risk factors of GERD occurrence.
authors.affiliation: Department of General Internal Medicine, Prefectural Hiroshima Hospital, Hiroshima, Japan. mykmiya@f2.dion.ne.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Masao
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Makoto
authors.initials: M
authors.lastname: Nagano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Mio
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D002121:Calcium Channel Blockers / Q000009:adverse effects; D003248:Constipation / Q000150:complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D016481:Helicobacter Infections / Q000150:complications / Q000201:enzymology / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood; D012307:Risk Factors; D012423:Rural Health; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000907:Antibodies, Bacterial; D002121:Calcium Channel Blockers; D010435:Pepsinogens