title: Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects - a retro-pro study.
abstract: BACKGROUND
  Information about gastro-oesophageal reflux disease (GERD) in patients with Diabetes mellitus type 2 (T2D) is scarce, although the incidence of both disorders is increasing.
  
  
  METHODS
  This "retro-pro" study compared 65 T2D patients to a control group of 130 age- and sex-matched non-diabetics. GERD was confirmed by gastroscopy, manometry, pH-metry and barium swallow.
  
  
  RESULTS
  In patients with T2D compared to controls, dysphagia (32.3% vs. 13.1%; p = 0.001) and globus sensation (27.7% vs. 13.8%; p = 0.021) were found more frequently, whereas heartburn (76.9% vs. 88.5%; p = 0.046) and regurgitation (47.7% vs. 72.3%; p= 0.001) were predominant in non-diabetics. Despite higher body mass indices (31.1 ± 5.2 vs. 27.7 ± 3.7 kg/m²; p < 0.001), hiatal hernia was less frequent in T2D patients compared to controls (60.0% vs. 90.8%, p < 0.001). Lower oesophageal sphincter (LES) pressure was higher in patients with T2D (median 10.0 vs. 7.2 mmHg, p = 0.016). DeMeester scores did not differ between the groups. Helicobacter pylori infections were more common in T2D patients (26.2% vs. 7.7%, p = 0.001). Barrett metaplasia (21.5% vs. 17.7%), as well as low- (10.8% vs. 3.8%) and high-grade dysplasia (1.5% vs. 0%) were predominant in T2D patients.
  
  
  CONCLUSIONS
  T2D patients exhibit different GERD symptoms, higher LES pressures and a decreased prevalence of hiatal hernia than non-diabetics, which may be related to worse oesophageal motility and, thus, a more functional rather than anatomical cause of GERD. Low-grade dysplasia was more than twice as high in T2D than in non-diabetics patients.
  
  
  BACKGROUND
  Ethics committee of the Medical University of Vienna, IRB number 720/2011.
authors: Regina
authors: R
authors: Promberger
authors: Johannes
authors: J
authors: Lenglinger
authors: Otto
authors: O
authors: Riedl
authors: Gernot
authors: G
authors: Seebacher
authors: Wolf
authors: W
authors: Eilenberg
authors: Johannes
authors: J
authors: Ott
authors: Franz
authors: F
authors: Riegler
authors: Michael
authors: M
authors: Gadenstätter
authors: Christoph
authors: C
authors: Neumayer
mesh_terms: D001466:Barium Sulfate; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008365:Manometry; D008991:Monitoring, Physiologic; D011312:Pressure; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies
chemical_list: D001466:Barium Sulfate
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