Department of Internal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Division of Gastroenterology & Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Neurogastroenterol Motil. 2022 Jul;34(7):e14295. doi: 10.1111/nmo.14295. Epub 2021 Dec 3.
Gastroesophageal reflux disease (GERD) has been associated with psychiatric and neurocognitive disorders. Those with autism spectrum disorder (ASD) are prone to gastrointestinal (GI) diseases, but most research has been done on children. Our aim was to determine the relationship between GERD and autism in adults and assess GERD-related complications in those with autism.
A national cohort of adults aged 18 and above with GERD with and without ASD were compared to those without GERD. Complications of GERD that were studied included Barrett's esophagus, erosive esophagitis, esophageal stricture, ulcer, and malignancy. Conditions associated with GERD were evaluated including chronic cough, wheezing, sore throat, non-cardiac chest pain, and hoarseness. GERD treatment that was evaluated included proton pump inhibitors (PPIs), H2 receptor antagonists (H2RA), and anti-reflux surgery.
There was an increased risk of GERD in subjects with ASD (p = 0.0001). Erosive esophagitis and esophageal ulcer were more likely to occur in those with GERD and ASD (p = 0.0001). Those with ASD were at higher risk of suffering from wheezing following a diagnosis of GERD compared to those without ASD (p = 0.0001). Those with GERD and ASD were more likely to be treated with an H2RA both as monotherapy and in combination with PPI versus those without ASD (p = 0.0001 and p = 0.0037, respectively).
Adult patients with ASD are more likely to have GERD as well as complications including erosive esophagitis and esophageal ulcer. Treatment of patients with GERD and ASD is not consistent and may suggest health care disparities.
胃食管反流病（GERD）与精神和神经认知障碍有关。自闭症谱系障碍（ASD）患者易患胃肠道（GI）疾病，但大多数研究都针对儿童。我们的目的是确定成人 GERD 与自闭症之间的关系，并评估自闭症患者的 GERD 相关并发症。
比较了患有和不患有 ASD 的成人 GERD 患者与无 GERD 患者的全国性队列。研究的 GERD 相关并发症包括 Barrett 食管、糜烂性食管炎、食管狭窄、溃疡和恶性肿瘤。评估了与 GERD 相关的疾病，包括慢性咳嗽、喘息、喉咙痛、非心源性胸痛和声音嘶哑。评估了 GERD 的治疗方法，包括质子泵抑制剂（PPIs）、H2 受体拮抗剂（H2RA）和抗反流手术。
ASD 患者发生 GERD 的风险增加（p=0.0001）。GERD 和 ASD 患者更有可能发生糜烂性食管炎和食管溃疡（p=0.0001）。与无 ASD 患者相比，GERD 诊断后喘息的发生风险更高（p=0.0001）。与无 ASD 患者相比，GERD 和 ASD 患者更有可能单独或联合使用 H2RA 治疗（p=0.0001 和 p=0.0037）。
患有 ASD 的成年患者更有可能患有 GERD 及其并发症，包括糜烂性食管炎和食管溃疡。GERD 和 ASD 患者的治疗并不一致，这可能表明存在医疗保健差异。
