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Natural history of gastroesophageal reflux: A prospective cohort study in a stratified, randomized population in Beijing
Author(s) -
Fang Xiucai,
Zhu Liming,
Wu Dongsheng,
Wang Zhifeng,
Fei Guijun,
Chang Min,
Liu Fangyi,
Xin Haiwei,
Xu Tao,
Chen Wei,
Wen Ping,
Li Shan,
Zhao Wei,
Chen Weiguang,
Yao Fang,
Sun Xiaohong,
Han Shaomei,
Ke Meiyun
Publication year - 2019
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12799
Subject(s) - medicine , reflux , heartburn , odds ratio , prospective cohort study , confidence interval , population , cohort , cohort study , gastroenterology , demography , disease , environmental health , sociology
Objective To explore the natural history of and risk factors for gastroesophageal reflux (GER) in a prospective cohort in Beijing, China. Methods We selected adult participants using a stratified randomized method and performed initial surveys in 1996 and the current survey in 2008. Well‐trained investigators administered the survey questionnaire using face‐to‐face interviews. Reflux symptoms were evaluated by their intensity and frequency. GER was defined as heartburn, acid reflux, and food regurgitation at least once a week, and monthly reflux was defined as at least one of the above symptoms occurring 1‐3 days per month. Results The resurvey response rate was 47.8% (1189/2486). Over 12 years, 66.9% of the respondents remained unchanged, and one‐third changed, with a GER new onset rate of 7.0 per 1000 person‐years and a GER disappearance rate of 64.6 per 1000 person‐years. This kept the GER prevalence stable at 8.2% to 9.5% ( P = 0.28). GER and monthly reflux exhibited significant differences in their tendency to persist or become aggravated to GER (22.4% vs 11.9%, P = 0.02). Participants who initially had single, mild to moderate, daily GER were more likely to recover from reflux over time. Participants with persistent and aggravated GER had more severe heartburn and acid reflux than those with new‐onset GER in the current survey. Multiple logistic regression analysis showed that emotional depression is a risk factor for GER aggravation (odds ratio 3.52, 95% confidence interval 1.43‐8.67, P = 0.006). Conclusion The initial symptom profile of reflux determines the outcome of GER over time.