1.A comparison of clinical characteristics between non-erosive reflux disease and reflux esophagitis
Hongyan PAN ; Xuelian XIANG ; Shangze LYU ; Xiaoping XIE ; Xiaohua HOU
Chinese Journal of Internal Medicine 2016;55(7):510-514
Objective To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE),which is helpful to the differential diagnosis.Methods Outpatients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study.Clinical data were comprehensively collected.Incidence of disease,severity,frequency of esophageal and extraesophageal symptoms,and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.Results Totally 446 subjects were recruited,including 225 patients with NERD and 221patients with RE.The occurrence rates of esophageal symptoms including heartburn [76.0% (171/225) vs 52.0% (115/221),P < 0.01] and acid regurgitation [74.7% (168/225) vs 54.3% (120/221),P <0.05] in NERD group were significantly higher than those in RE patients,with more severe and frequent (P < 0.05).Despite the rates of food regurgitation were similar,NERD patients behaved more severely and frequently (P < 0.05).Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9% (92/225) vs 27.6% (61/221),42.2% (95/225) vs 31.7% (70/221),all P <0.05] were also higher than those in RE group,the degree of which was more severe too (P < 0.05).RE patients claimed a higher proportion of chronic cough.The incidences of overlapping with IBS in two groups were similar.But there were more patients with FD in NERD group [72.0% (162/225) vs 62.9% (139/221),P < 0.05] than in RE group.Conclusions The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different,as well as comorbidities such as FD and IBS.These results suggest that NERD and RE are independent diseases.
2.Differences in lifestyle factors between functional constipation and constipation-predominant irritable bowel syndrome
Chang LUO ; Shangze LYU ; Tao BAI ; Xuelian XIANG ; Xiaohua HOU
Chinese Journal of Digestion 2015;(7):460-464
Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle factors were collected.First,single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed.Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group (all P >0.05).The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group.According to decision tree model analysis,body mass index (BMI),water intake per day and constipation family history were finally enrolled.The incidence of FC was higher in patients with BMI < 23.56 kg/m2 (except 18.74 to < 19.83 kg/m2 )(79.75 %).The incidence of FC was higher in patients with BMI from 18.74 to <19.83 kg/m2 and water intake <1 L
(66.67%).The incidence of FC was highest in patients with BMI≥23.56 kg/m2 and family history of constipation (70.00%).The total prediction accuracy of this model was 64.6% (42/65 )and area under curve (AUC)value was 0.688.Conclusions FC and IBS-C are related with many lifestyle factors.Low BMI and less water intake per day are influence factors of FC,while higher BMI and family history of constipation are influence factors of IBS-C.