title: Atypical symptoms and health-related quality of life of patients with asymptomatic reflux esophagitis.
abstract: OBJECTIVE
  Asymptomatic reflux esophagitis (RE) is simply regarded as RE without the typical reflux symptoms, but it is unknown whether patients with asymptomatic RE have atypical symptoms. The aim of this study was to examine the clinical characteristics and health-related quality of life (HRQOL) of patients with asymptomatic RE.
  
  
  METHODS
  Consecutive patients with RE were enrolled during January 2010 to August 2012, and of them, 41 who had taken acid-suppressing drugs were excluded, leaving 280 patients as the study group. The patients' symptoms were evaluated using a self-completed questionnaire (modified Frequency Scale for the Symptoms of gastroesophageal reflux disease [FSSG]), as well as an HRQOL questionnaire (SF-8). We defined the typical symptoms of RE as heartburn and regurgitation. Asymptomatic RE was defined if the total symptom score was 0 or the minimum (1 point) for typical reflux symptoms in the modified FSSG.
  
  
  RESULTS
  Of the 280 RE patients, 71.8% (n = 201) were symptomatic and 28.2% (n = 79) were asymptomatic. The atypical symptom scores were significantly lower in asymptomatic RE (2.2 ± 2.2) than in symptomatic RE patients (6.9 ± 5.2) (P < 0.0001), and the HRQOL scores were significantly higher in asymptomatic RE than in symptomatic RE (P < 0.0001). Sleep was significantly less disturbed and chronic cough less frequent in asymptomatic RE than in symptomatic RE.
  
  
  CONCLUSIONS
  Frequency and severity of atypical symptoms in patients with asymptomatic RE were significantly less than in patients with symptomatic RE, and the HRQOL score was significantly higher in those patients. These observations suggest a specific patient cohort that is truly unlikely to manifest symptoms.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tomita
authors.forename: Toshinari
authors.initials: T
authors.lastname: Yasuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Oka
authors.forename: Shuichi
authors.initials: S
authors.lastname: Terao
authors.forename: Eitastu
authors.initials: E
authors.lastname: Arai
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Hori
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D004942:Esophagitis, Peptic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006356:Heartburn; D006801:Humans; D057045:Laryngopharyngeal Reflux; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: HRQOL; asymptomatic reflux esophagitis; atypical symptoms