The influence of co‐morbid IBS and psychological distress on outcomes and quality of life following PPI therapy in patients with gastro‐oesophageal reflux disease
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Summary: Background A subset of patients with gastro‐oesophageal reflux disease (GERD) does not achieve complete symptom resolution with proton pump inhibitor (PPI) therapy. The factors which affect response to PPI therapy in GERD patients remain unclear. Aims To determine the prevalence and impact of irritable bowel syndrome (IBS) and psychological distress (PD) on GERD symptoms and disease‐specific quality of life (QoL) before and after PPI therapy and to assess the same outcomes before and after PPI therapy in non‐erosive reflux disease (NERD) and erosive oesophagitis (EO) GERD patients. Methods Patients undergoing oesophago‐gastroduodenoscopy (OGD) for heartburn were recruited. Participants completed validated surveys: Digestive Health Symptom Index, Reflux Disease Questionnaire, Quality of Life in Reflux and Dyspepsia and Brief Symptom Inventory (BSI). IBS was defined as >3 Manning criteria and PD as BSI score >63. At OGD, patients were classified as NERD or EO. Patients were treated with rabeprazole 20 mg/day for 8 weeks before completing follow‐up surveys. Results Of 132 GERD patients enrolled, 101 completed the study. The prevalence rates of IBS and PD were 36% and 41%, respectively. IBS independently predicted worse QoL before and after PPI therapy. PD independently predicted worse GERD symptoms and QoL before and after PPI therapy. There were no differences in symptoms or QoL between NERD and EO patients before or after PPI therapy. Conclusions IBS and PD impacted GERD symptoms and QoL before and after PPI therapy. Symptoms and QoL before and after PPI therapy were similar in NERD and EO patients.
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The concomitant presence of IBS or psychological distress in GERD patients predicted higher symptom ratings and lower quality of life before and after PPI treatment.
“In addition, the concomitant presence of IBS or psychological distress in GERD patients predicted higher symptom ratings and lower quality of life before and after PPI treatment, making this subset of patients a therapeutic challenge.20”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [20]
The ‘Impact of co-morbid PD on GERD symptoms and QoL’ section supports higher symptom burden and worse disease-specific quality of life before and after PPI therapy among patients with psychological distress. The ‘Impact of co-morbid IBS’ section supports higher symptoms and worse quality of life before treatment, but IBS was not associated with post-treatment symptom scores, and its lower post-treatment quality-of-life scores were not statistically significant. The claim overstates the post-treatment findings for IBS. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAnother study found 36 percent prevalence of IBS in GERD patients.
“Another study found 36 percent prevalence of IBS in GERD patients.”
From Irritable Bowel Syndrome and Co-morbid Gastrointestinal and Extra-gastrointestinal Functional Syndromes (2010) · cites this paper as [20]
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ОСОБЛИВОСТІ ПСИХОЛОГІЧНОЇ ДЕЗАДАПТАЦІЇ ПАЦІЄНТІВ ІЗ ГАСТРОЕЗОФАГЕАЛЬНОЮ РЕФЛЮКСНОЮ ХВОРОБОЮ
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- Authors
- NOJKOV, B., RUBENSTEIN, J. H., ADLIS, S. A., SHAW, M. J., SAAD, R., RAI, J., WEINMAN, B., & CHEY, W. D.
- Affiliations
- University of Michigan (US)
- Park Nicollet Health Services (US)
- Corresponding author
- CHEY, W. D.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2008-01-10
- Volume
- 27
- Issue
- 6
- Pages
- 473-482
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2136938649
- Cited by
- 101
- References
- 42
- Citations by year
- 2025: 5 · 2024: 3 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 6 · 2014: 11 · 2013: 12 · 2012: 12
- FWCI
- 9.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- Janssen Scientific Affairs
- Eisai
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Keywords
- gastroesophageal reflux disease, irritable bowel syndrome, psychological distress, proton pump inhibitors, rabeprazole, non-erosive reflux disease, erosive esophagitis, quality of life, heartburn, treatment response, comorbidities
- MeSH terms
- Adolescent, Adult, Aged, Female, Gastroesophageal Reflux, Heartburn, Humans, Male, Middle Aged, Quality of Life, Stress, Physiological, Proton Pumps, Irritable Bowel Syndrome, 2-Pyridinylmethylsulfinylbenzimidazoles, Proton Pump Inhibitors, Rabeprazole
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