Lifestyle factors associated with gastroesophageal reflux disease in the Japanese population.
BACKGROUND
We aimed to clarify the lifestyle factors associated with erosive esophagitis and non-erosive reflux disease (NERD) in a Japanese population.


METHODS
Among 886 subjects who underwent health screening, we selected, according to their scores on the FSSG (frequency scale for symptoms of gastroesophageal reflux disease; GERD) questionnaire and the findings of upper gastrointestinal endoscopy, 138 subjects with erosive esophagitis (EE), 148 subjects with NERD (absence of esophagitis, FSSG score ≥8, and acid reflux-related symptoms score ≥4), and 565 control subjects (absence of esophagitis and FSSG score ≤7). We compared clinical characteristics and various lifestyle factors in these three groups.


RESULTS
The lifestyle factors significantly associated with NERD compared with findings in the control group were intake of egg (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.01-3.50), sleep shortage (OR 2.44, 95% CI 1.54-3.88), and strong psychological stress (OR 1.77, 95% CI 1.18-2.62). In male subjects, current smoking (OR 2.06, 95% CI 1.13-3.74; OR 1.87, 95% CI 1.09-3.20) was a significant risk factor for both NERD and EE. Moreover, alcohol >200 kcal/day (OR 3.99, 95% CI 1.03-15.55) and intake of a large quantity of food at supper (OR 7.85, 95% CI 1.66-37.05) were significant risk factors for EE in subjects with hiatal hernia. Intake of a large quantity of food at supper (OR 2.09, 95% CI 1.06-4.13) was more common in the NERD group than in the EE group.


CONCLUSIONS
There were differences in the associated lifestyle factors between patients with NERD and those with EE, and there was also a gender-related difference between these groups.
Department of Gastroenterology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Nobuyuki
N
Matsuki
Tsuyoshi
T
Fujita
Naoya
N
Watanabe
Atsushi
A
Sugahara
Akihiko
A
Watanabe
Tsukasa
T
Ishida
Yoshinori
Y
Morita
Masaru
M
Yoshida
Hiromu
H
Kutsumi
Takanobu
T
Hayakumo
Hidekazu
H
Mukai
Takeshi
T
Azuma
D000328:Adult; D015992:Body Mass Index; D004032:Diet / Q000009:adverse effects / Q000706:statistics & numerical data; D004531:Eggs / Q000009:adverse effects; D016099:Endoscopy, Gastrointestinal; D004942:Esophagitis, Peptic / Q000209:etiology; D005247:Feeding Behavior; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000150:complications; D012907:Smoking / Q000009:adverse effects; D013315:Stress, Psychological / Q000150:complications