Night-time and daytime atypical manifestations of gastro-oesophageal reflux disease: frequency, severity and impact on health-related quality of life.

BACKGROUND

Respondents with gastro-oesophageal reflux disease (GERD) report having a variety of atypical manifestations. The relationship between these manifestations and disease severity, night-time GERD and functioning has not been determined.

AIM

To determine if atypical manifestations are related to increased disease severity, night-time GERD and decreased functioning.

METHODS

A web survey among US adults was conducted, using a validated GERD screener. Frequency of night-time and daytime typical symptoms (acid regurgitation and heartburn) and atypical manifestations were assessed. Respondents were classified as night-time GERD or daytime GERD based on typical symptom frequency. Prevalence of frequent atypical manifestations (> or =2 days or nights/week) was assessed.

RESULTS

Gastro-oesophageal reflux disease cases had a higher prevalence of each atypical manifestation (P < 0.05 for all) compared with controls. Night-time GERD respondents had a higher prevalence of atypical manifestations compared with daytime GERD respondents (P < 0.05 for most manifestations) and the prevalence of atypical manifestations increased with GERD symptom severity (P < 0.05 for most). Those with atypical manifestations reported lower functioning scores (P < 0.05 for most).

CONCLUSIONS

Respondents with typical GERD symptoms commonly report atypical manifestations, especially those with night-time symptoms and those with greater underlying GERD severity. Respondents with GERD and atypical manifestations had more impaired functioning than those with typical symptoms only.