title: Risk factors associated with gastroesophageal reflux disease relapse in primary care patients successfully treated with a proton pump inhibitor.
abstract: BACKGROUND
  There are no studies on the factors associated with gastroesophageal reflux disease (GERD) relapse in primary care patients.
  
  
  OBJECTIVE
  To identify the risk factors associated with GERD relapse in primary care patients that responded adequately to short-term treatment with a proton pump inhibitor.
  
  
  METHODS
  A cohort study was conducted that included GERD incident cases. The patients received treatment with omeprazole for 4 weeks. The ReQuest questionnaire and a risk factor questionnaire were applied. The therapeutic success rate and relapse rate were determined at 4 and 12 weeks after treatment suspension. A logistic regression analysis of the possible risk factors for GERD relapse was carried out.
  
  
  RESULTS
  Of the 83 patient total, 74 (89.16%) responded to treatment. Symptoms recurred in 36 patients (48.64%) at 4 weeks and in 13 patients (17.57%) at 12 weeks, with an overall relapse rate of 66.21%. The OR multivariate analysis (95% CI) showed the increases in the possibility of GERD relapse for the following factors at 12 weeks after treatment suspension: basic educational level or lower, 24.95 (1.92-323.79); overweight, 1.76 (0.22-13.64); obesity, 0.25 (0.01-3.46); smoking, 0.51 (0.06-3.88); and the consumption of 4-12 cups of coffee per month, 1.00 (0.12-7.84); citrus fruits, 14.76 (1.90-114.57); NSAIDs, 27.77 (1.12-686.11); chocolate, 0.86 (0.18-4.06); ASA 1.63 (0.12-21.63); carbonated beverages, 4.24 (0.32-55.05); spicy food 7-16 times/month, 1.39 (0.17-11.17); and spicy food ≥ 20 times/month, 4.06 (0.47-34.59).
  
  
  CONCLUSIONS
  The relapse rate after short-term treatment with omeprazole was high. The consumption of citrus fruits and NSAIDs increased the possibility of GERD relapse.
authors.affiliation: Dirección de Educación e Investigación, UMAE Hospital de Especialidades CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México. Electronic address: lopez_colombo@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: López-Colombo
authors.affiliation: Unidad de Medicina Familiar Número 1, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: M S
authors.initials: MS
authors.lastname: Pacio-Quiterio
authors.affiliation: Dirección de Educación e Investigación, UMAE Hospital de Especialidades CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: L Y
authors.initials: LY
authors.lastname: Jesús-Mejenes
authors.affiliation: Coordinación Auxiliar Médica de Educación en Salud, Delegación Puebla, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: J E G
authors.initials: JE
authors.lastname: Rodríguez-Aguilar
authors.affiliation: Unidad de Medicina Familiar Número 2, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: M
authors.initials: M
authors.lastname: López-Guevara
authors.affiliation: División de Investigación, UMAE Hospital de Traumatología y Ortopedia, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: A J
authors.initials: AJ
authors.lastname: Montiel-Jarquín
authors.affiliation: Dirección de Investigación, Hospital General de México Dr. Eduardo Liceaga, SSA, Ciudad de México, México.
authors.forename: J C
authors.initials: JC
authors.lastname: López-Alvarenga
authors.affiliation: Dirección General, UMAE Hospital de Especialidades CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: E R
authors.initials: ER
authors.lastname: Morales-Hernández
authors.affiliation: División de Epidemiología, UMAE Hospital de Especialidades CMN Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: V R
authors.initials: VR
authors.lastname: Ortiz-Juárez
authors.affiliation: Coordinación Auxiliar Médica de Investigación en Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.
authors.forename: L
authors.initials: L
authors.lastname: Ávila-Jiménez
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D015331:Cohort Studies; D004032:Diet; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D011320:Primary Health Care; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D009853:Omeprazole
keywords: Enfermedad por reflujo gastroesofágico; Factores de riesgo; Gastroesophageal reflux disease; Gastroesophageal reflux disease relapse; Inhibidores de la bomba de protones; Proton pump inhibitors; Recaída de enfermedad por reflujo gastroesofágico; Risk factors