title: Minimal differences in prevalence and spectrum of organic disease at upper gastrointestinal endoscopy between selected secondary care patients with symptoms of gastro-oesophageal reflux or dyspepsia.
abstract: OBJECTIVE
  Gastro-oesophageal reflux and dyspepsia are felt to be separate upper gastrointestinal (GI) conditions. We aimed to measure the degree of overlap between them, and assess whether endoscopic findings differed.
  
  
  METHODS
  Demographic, symptom, upper GI endoscopy and histology data were collected from consecutive adults in secondary care. Patients were categorised according to whether they reported gastro-oesophageal reflux alone, dyspepsia alone or both, and patient demographics and endoscopic findings were compared.
  
  
  RESULTS
  Of 1167 patients, 97 (8.3%) had gastro-oesophageal reflux alone, 571 (48.9%) dyspepsia alone, and 499 (42.8%) overlap. Patients with overlap symptoms were more likely to smoke, compared with those with gastro-oesophageal reflux alone, or dyspepsia alone (p = .009), but there were no other differences. Patients with gastro-oesophageal reflux alone or overlap had a higher prevalence of erosive oesophagitis (18.6% and 15.4% respectively, p < .001), but this was still the commonest diagnosis among those with dyspepsia alone (7.2%). No significant differences were seen in prevalence of other endoscopic findings.
  
  
  CONCLUSIONS
  Gastro-oesophageal reflux and dyspepsia symptoms commonly overlap. There were minimal differences in demographics or spectrum of underlying organic disease between various symptom groups, suggesting that restrictive classifications according to predominant symptom may not be clinically useful.
authors.affiliation: a Leeds Gastroenterology Institute, St. James's University Hospital , Leeds , UK.|b Leeds Institute of Biomedical and Clinical Sciences, University of Leeds , Leeds , UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Irvine
authors.affiliation: c Gastroenterology Division, Farncombe Family Digestive Health Research Institute , McMaster University, Health Sciences Center , Hamilton , Ontario , Canada.
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Pinto-Sanchez
authors.affiliation: c Gastroenterology Division, Farncombe Family Digestive Health Research Institute , McMaster University, Health Sciences Center , Hamilton , Ontario , Canada.
authors.forename: Premysl
authors.initials: P
authors.lastname: Bercik
authors.affiliation: c Gastroenterology Division, Farncombe Family Digestive Health Research Institute , McMaster University, Health Sciences Center , Hamilton , Ontario , Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Moayyedi
authors.affiliation: a Leeds Gastroenterology Institute, St. James's University Hospital , Leeds , UK.|b Leeds Institute of Biomedical and Clinical Sciences, University of Leeds , Leeds , UK.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Ford
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004415:Dyspepsia / Q000000981:diagnostic imaging* / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000473:pathology*; D006356:Heartburn / Q000209:etiology; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009864:Ontario; D063127:Secondary Health Care; D055815:Young Adult
keywords: Epigastric pain; endoscopy; heartburn; regurgitation