Ogasawara Naotaka, Funaki Yasushi, Kasugai Kunio, Ebi Masahide, Tamura Yasuhiro, Izawa Shinya, Sasaki Makoto
Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
J Neurogastroenterol Motil. 2022 Apr 30;28(2):291-302. doi: 10.5056/jnm21065.
BACKGROUND/AIMS: Detailed evaluations of overlapping constipation and gastroesophageal reflux disease (GERD) have not been conducted in Japan. The REACTION-J2 study examined the overlap of these diseases in Japan.
This internet-based survey recruited participants from general public survey panels. Questions included demographic and medical data and assessments based on validated measures for constipation and GERD. Associations between background factors affecting constipation/GERD overlap, disease measures, and treatment were also evaluated.
Among 10 000 survey responses received, functional constipation (Rome IV diagnostic criteria) was reported by 439 participants; chronic constipation (Japanese guidelines) by 3804 participants; and subjective constipation symptoms by 2563 participants. The number of participants with constipation/GERD overlap ranged from 73 to 1533 depending on the criteria used. Regardless of the definition used, all GERD groups had significantly higher odds of being constipated than non-GERD participants: the OR (95% CI) for all 9 combinations of definitions ranged between 1.56 (1.21, 2.01) and 2.67 (2.44, 2.92) (all ≤ 0.001). Straining, hard stools, and sensations of incomplete evacuation and anorectal obstruction/blockage, according to chronic constipation criteria, were common. Participants with constipation/GERD overlap had poorer quality of life ( < 0.001) and worse GERD symptom scores ( < 0.001). The frequency of abnormal stools was highest ( < 0.001) in the constipation/GERD overlap group. In the overlap group, 52.4% and 26.0% used gastric and constipation medication, respectively.
Individuals with constipation/GERD overlap tend to have worsened symptoms and quality of life.
背景/目的：日本尚未对重叠性便秘和胃食管反流病（GERD）进行详细评估。REACTION-J2研究调查了日本这些疾病的重叠情况。
这项基于互联网的调查从公众调查小组中招募参与者。问题包括人口统计学和医学数据，以及基于便秘和GERD有效测量方法的评估。还评估了影响便秘/GERD重叠的背景因素、疾病测量指标和治疗之间的关联。
在收到的10000份调查回复中，439名参与者报告有功能性便秘（罗马IV诊断标准）；3804名参与者报告有慢性便秘（日本指南）；2563名参与者报告有主观便秘症状。根据所使用的标准，便秘/GERD重叠的参与者人数在73至1533人之间。无论使用何种定义，所有GERD组便秘的几率均显著高于非GERD参与者：所有9种定义组合的OR（95%CI）在1.56（1.21，2.01）至2.67（2.44，2.92）之间（均≤0.001）。根据慢性便秘标准，用力排便、大便干结、排便不尽感和肛门直肠梗阻/堵塞感很常见。便秘/GERD重叠的参与者生活质量较差（<0.001），GERD症状评分更差（<0.001）。便秘/GERD重叠组异常大便的频率最高（<0.001）。在重叠组中，分别有52.4%和26.0%的人使用胃药和便秘药。
便秘/GERD重叠的个体往往症状更严重，生活质量更差。
