Gastroesophageal reflux symptoms and well-being in a random sample of the general population of a swedish community

• Published in: The American journal of gastroenterology Vol. 101; no. 1; pp. 18 - 28
• Main Authors: WIKLUND, Ingela, CARLSSON, Jonas, VAKIL, Nimish
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing 2006; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Adaptation, Physiological; Adaptation, Psychological; Adult; Age Factors; Aged; Biological and medical sciences; Cross-Sectional Studies; Esophagus; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - diagnosis; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - psychology; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Other diseases. Semiology; Probability; Prognosis; Quality of Life; Risk Assessment; Sampling Studies; Severity of Illness Index; Sex Factors; Sickness Impact Profile; Surveys and Questionnaires; Sweden - epidemiology; Urban Population; Sweden; Gastroesophageal reflux; Symptomatology; Esophageal disease; Gastroenterology; Digestive diseases; Well being; Quality of life
• DOI: 10.1111/j.1572-0241.2005.00343.x
• ISSN: 0002-9270

There is limited information on the relationship between gastroesophageal reflux symptoms and well-being in the general population. This study aimed to investigate this relationship and determine the severity threshold at which reflux symptoms meaningfully affect patients' well-being. A random sample of the population of Malmö, Sweden (n = 4,624), was sent the Gastrointestinal Symptom Rating Scale, the Subjective Symptom Assessment Profile, and the Psychological General Well-Being Index. The relationship between well-being and the severity of heartburn, acid regurgitation, stomach pain, and abdominal pain was investigated by analysis of covariance (ANCOVA). Complete data were obtained from 1,476 subjects (43% male; mean age [standard deviation], 49.9 [14.2] yr). The mean Psychological General Well-Being Index score was 102 (95% CI: 101-103). Increasing symptom severity was associated with a decrease in well-being, and correlations between Psychological General Well-Being Index score and symptom severity ratings were statistically significant. At least mild symptoms of heartburn or abdominal pain (a mean Gastrointestinal Symptom Rating Scale score of > or =3) were associated with a clinically meaningful reduction in well-being (a Psychological General Well-Being Index score of less than 98). Reflux symptoms are associated with impaired well-being in the general population. Individuals with symptoms that are mild or more severe report a meaningful reduction in well-being similar to that seen in other diseases. This may represent an appropriate threshold for patient selection in trials of GERD therapy and for more detailed evaluation of patients consulting with reflux symptoms in clinical practice.