title: Night-time and daytime atypical manifestations of gastro-oesophageal reflux disease: frequency, severity and impact on health-related quality of life.
abstract: BACKGROUND
  Respondents with gastro-oesophageal reflux disease (GERD) report having a variety of atypical manifestations. The relationship between these manifestations and disease severity, night-time GERD and functioning has not been determined.
  
  
  OBJECTIVE
  To determine if atypical manifestations are related to increased disease severity, night-time GERD and decreased functioning.
  
  
  METHODS
  A web survey among US adults was conducted, using a validated GERD screener. Frequency of night-time and daytime typical symptoms (acid regurgitation and heartburn) and atypical manifestations were assessed. Respondents were classified as night-time GERD or daytime GERD based on typical symptom frequency. Prevalence of frequent atypical manifestations (> or =2 days or nights/week) was assessed.
  
  
  RESULTS
  Gastro-oesophageal reflux disease cases had a higher prevalence of each atypical manifestation (P < 0.05 for all) compared with controls. Night-time GERD respondents had a higher prevalence of atypical manifestations compared with daytime GERD respondents (P < 0.05 for most manifestations) and the prevalence of atypical manifestations increased with GERD symptom severity (P < 0.05 for most). Those with atypical manifestations reported lower functioning scores (P < 0.05 for most).
  
  
  CONCLUSIONS
  Respondents with typical GERD symptoms commonly report atypical manifestations, especially those with night-time symptoms and those with greater underlying GERD severity. Respondents with GERD and atypical manifestations had more impaired functioning than those with typical symptoms only.
authors.affiliation: Cerner LifeSciences, Beverly Hills, CA 90212, USA. bdean@cerner.com
authors.forename: B B
authors.initials: BB
authors.lastname: Dean
authors.forename: D
authors.initials: D
authors.lastname: Aguilar
authors.forename: L F
authors.initials: LF
authors.lastname: Johnson
authors.forename: J E
authors.initials: JE
authors.lastname: McGuigan
authors.forename: W C
authors.initials: WC
authors.lastname: Orr
authors.forename: R
authors.initials: R
authors.lastname: Fass
authors.forename: N
authors.initials: N
authors.lastname: Yan
authors.forename: D
authors.initials: D
authors.lastname: Morgenstern
authors.forename: R W
authors.initials: RW
authors.lastname: Dubois
mesh_terms: D000328:Adult; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires