title: Frequency and clinical implications of supraesophageal and dyspeptic symptoms in gastroesophageal reflux disease.
abstract: OBJECTIVE
  We studied the frequency of supraesophageal and dyspeptic symptoms and their impact on the quality of life (QoL) and treatment response in patients with gastroesophageal reflux disease (GERD).
  
  
  METHODS
  Multicenter, prospective, observational study of patients who consulted a gastroenterologist because of typical GERD symptoms. Upper digestive symptoms were assessed using direct interviews. The Short Form-12 and the Quality of Life in Reflux and Dyspepsia questionnaires were used to measure QoL. Patients were treated with proton pump inhibitors (PPIs).
  
  
  RESULTS
  A total of 301 patients (58% men; mean age, 45 years) were included. Baseline symptoms were heartburn (99% of cases; nocturnal heartburn 78%), regurgitation (86%), both heartburn and regurgitation (85%), dyspeptic symptoms (91%; epigastric pain syndrome 20%, postprandial distress syndrome 4%, both 75%), and supraesophageal symptoms (58%). In 56% of cases of heartburn, 35% of regurgitation, and 34% of nocturnal heartburn, symptoms were severe or very severe. One in six patients had dysphagia. Supraesophageal and/or dyspeptic symptoms were associated with worse scores on the Short Form-12 and Quality of Life in Reflux and Dyspepsia instruments. After treatment, heartburn and regurgitation disappeared in 93 and 87% of the patients, respectively. The percentage of patients responding to PPI treatment was significantly higher (P<0.05) in those with heartburn than those without heartburn (96 vs. 86%) and in those with regurgitation than without regurgitation (95 vs. 83%), whereas no differences were observed in those with and without supraesophageal or dyspeptic symptoms.
  
  
  CONCLUSIONS
  Patients with typical GERD symptoms (heartburn and/or regurgitation) very frequently have dyspeptic and supraesophageal manifestations, which are related to a worse QoL but unrelated to PPI response.
authors.affiliation: Service of Gastroenterology, Centro Médico Teknon, Barcelona, Spain. fmearinm@meditex.es
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
authors.forename: Julio
authors.initials: J
authors.lastname: Ponce
authors.forename: Marta
authors.initials: M
authors.lastname: Ponce
authors.forename: Agustín
authors.initials: A
authors.lastname: Balboa
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Gónzalez
authors.forename: Javier
authors.initials: J
authors.lastname: Zapardiel
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004415:Dyspepsia / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D006356:Heartburn / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011594:Psychometrics; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors