Nonsteroidal anti-inflammatory drug use as a risk factor for gastro-oesophageal reflux disease: an observational study.
BACKGROUND
Although the associations between nonsteroidal anti-inflammatory drugs (NSAIDs) and peptic ulcer disease or dyspepsia are well established, fewer data exist concerning the relationship between NSAIDs and gastro-oesophageal reflux disease (GERD).


OBJECTIVE
To examine the relationship between NSAIDs and GERD.


METHODS
A self-administered questionnaire covering NSAID use and GERD symptoms (heartburn and acid regurgitation) was sent to a representative national sample of 10,000 French adults (> or = 18 years) between 14 October and 21 November 2005. Risk factors associated with GERD were identified by logistic regression analysis in respondents who were not taking aspirin or proton pump inhibitors.


RESULTS
A total of 7259 completed questionnaires were returned of which 6823 were evaluable. Overall, 2262 respondents (33%) reported using NSAIDs during the previous 3 months. The lifetime and 3-month prevalence rates of GERD symptoms were 37% and 21% respectively. GERD symptoms were significantly more common among NSAID users than among non-users (27% vs. 19%, P < or = 0.001) and a similar trend was seen for aspirin use. Proton pump inhibitors were received by 31% of respondents who reported experiencing GERD symptoms within the previous 3 months compared with 6% of those without symptoms (P < 0.01); however, only 20% of NSAID-treated respondents were receiving proton pump inhibitors. NSAID use, age and female gender were independent predictors of GERD symptoms.


CONCLUSIONS
NSAID or aspirin use is a significant risk factor for GERD symptoms.
Ruszniewski
P
P
Department of Gastroenterology, Beaujon Hospital, Clichy, France. philippe.ruszniewski@bjn.aphp.fr
Soufflet
C
C
Barthélémy
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D005260:Female; D005764:Gastroesophageal Reflux / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012307:Risk Factors; D012651:Self Medication; D011795:Surveys and Questionnaires; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D001241:Aspirin