Gastroesophageal reflux disease in patients with long standing type 1 diabetes mellitus: utility of two self-report questionnaires in a multifactorial disease
Article Sidebar
Main Article Content
Background:
Gastroesophageal pathologies are common and multifactorial in patients with type 1 diabetes (T1DM). The evaluation with endoscopy and 24 h pH esophageal monitoring is expensive and not always available in all medical centers, especially in developing countries so more cost-effective algorithms for diagnosis are required. Clinical questionnaires are easy to apply but its utility for gastroesophageal reflux disease screening in patients with long standing T1DM must be analyzed.
Objective:
To evaluate the utility of the FSSG and Carlsson-Dent (CDQ) questionnaires to detect the frequency of gastroesophageal reflux disease in patients with T1DM.
Methods:
Analytic cross-sectional study, included 54 randomly selected patients from the T1DM clinic in our hospital. Before their routine evaluation, were asked to answer FSSG and CDQ questionnaires, classifying them as positive with a score >8 or >4, respectively. we associated and compared the clinical and biochemical characteristics between patients with or without gastroesophageal reflux detected through questionnaires.
Results:
Median age was 29 years (22-35), 67% were female (median of 16 years from diagnosis). In 39% of the patients FSSG was positive, CDQ was positive in 28%. A total of 71% of patients were taking medications to treat non-specific gastric symptoms. The concordance between questionnaires was 65% (p: <0.001). Those patients with tobacco consumption as well as those with poor glycemic control were more likely to score positive in either questionnaire.
Conclusions:
Patients T1DM had a high prevalence of gastroesophageal reflux disease. In those patients FSSG questionnaire detected a higher number of patients in comparison with CDQ.
- gastroesophageal reflux
- type 1 diabetes mellitus
- surveys and questionnaires
Promberger R, Lenglinger J, Riedl O, Seebacher G, Eilenberg W, Ott J. Gastro-oesophageal reflux disease in type 2 diabetics symptom load and pathophysiologic aspects -a retro-pro study. BMC Gastroenterology. 2013;13:132. DOI: https://doi.org/10.1186/1471-230X-13-132
Koch CA, Uwaifo GI. Are gastrointestinal symptoms related to diabetes mellitus and glycemic control. European J Gastroenterol Hepatol. 2008; 20(9): 822–5. DOI: https://doi.org/10.1097/MEG.0b013e3282f5f75e
Promberger R, Spitzer A, Ott J, Lenglinger J, Eilenberg W, Gadenstätter M. Quality of life in type 2 diabetics with gastroesophageal reflux disease a case control study. European Surgery. 2013; 45(4): 194–9. DOI: https://doi.org/10.1007/s10353-013-0219-7
Scholten T. Long-term management of gastroesophageal reflux disease with pantoprazole. Ther Clin Risk Manag. 2007; 3(2): 231–43. DOI: https://doi.org/10.2147/tcrm.2007.3.2.231
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diab. 2008; 26(2): 77–82. DOI: https://doi.org/10.2337/diaclin.26.2.77
.Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol. 1998; 33(10): 1023–9. DOI: https://doi.org/10.1080/003655298750026697
Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K. Development and evaluation of FSSG frequency scale for the symptoms of GERD. J Gastroenterol. 2004; 39(9): 888–91. DOI: https://doi.org/10.1007/s00535-004-1417-7
Hernandez-Lozada VH, Garcia AJ. Correlation betweenesophageal pathology and the Carlsson-Dent questionnaire in patients under esophageal-gastric duodenoscopy. Rev Mex Cir Aparato Digestivo. 2012; 1(1): 33–8.
Trujillo-Benavides OE, Baltazar-Montufar PdeJ, Angeles-Garay U, Ramirez-Mendoza P, Navarro-Garcia AM, Paredes-Cruz E. Asociación entre reflujo gastroesofágico sintomático y esófago de Barrett. Rev Gastroenterol Mexico. 2005; 70(1): 14–9.
Zavala-Gonzales MA, Azamar-Jacome AA, Meixueiro-Daza A, Ramos A, J JR, Roesch-Dietlen F. Validation and diagnostic usefulness of gastroesophageal reflux disease questionnaire in a primary care level in Mexico. J Neurogastroenterol Motil. 2014; 20(4): 475–82. DOI: https://doi.org/10.5056/jnm.20.475.
Hirata A, Kishida K, Nakatsuji H, Inoue K, Hiuge-Shimizu A, Funahashi T. High prevalence of gastroesophageal reflux symptoms in type 2 diabetics with hypoadiponectinemia and metabolic syndrome. Nutrition Metabolism. 2012; 9(1): 4. DOI: https://doi.org/10.1186/1743-7075-9-4
Horikawa A, Ishii-Nozawa R, Ohguro M, Takagi S, Ohtuji M, Yamada M. Prevalence of GORD (gastro-oesophageal reflux disease) in Type 2 diabetes and a comparison of clinical profiles between diabetic patients with and without GORD. Diabetic Medicine. 2009; 26(3): 228–33. DOI: https://doi.org/10.1111/j.1464-5491.2009.02671.x
Anonimus Standards of Medical Care in Diabetes-2017: summary of revisions. Diabetes Care. 2017; 40(Suppl 1): S4–S5. DOI: https://doi.org/10.2337/dc17-S003
Gomez-Escudero O, Remes-Troche JM, Ruiz JC, Pelaez-Luna M, Schmulson MJ, Valdovinos DMA. Utilidad diagnostica del cuestionario de Carlsson-Dent en la enfermedad por reflujo gastroesofagico (ERGE) Rev Gastroenterol Mex. 2004; 69(1): 16-23.
Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974; 20(4): 470–5. DOI: https://doi.org/10.1093/clinchem/20.4.470
Warnick GR, Benderson J, Albers JJ. Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. Clin Chem. 1982; 28(6): 1379–88. DOI: https://doi.org/10.1093/clinchem/28.6.1379
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502. DOI: https://doi.org/10.1093/clinchem/18.6.499
Salis G. Revisión sistemática epidemiología de la enfermedad por reflujo gastroesofágico en Latinoamérica. Acta Gastroenterologica Latinoam. 2011; 41(1): 60–9.
Kaplan M, Tanoglu A, Sakin YS, Akyol T, Oncu K, Kara M. Landmark reading alterations in patients with gastro-oesophageal reflux symptoms undergoing diagnostic gastroscopy. Arab J Gastroenterol. 2016; 17(4): 176–80. DOI: https://doi.org/10.1016/j.ajg.2016.08.008
Netinatsunton N, Attasaranya S, Ovartlarnporn B, Sangnil S, Boonviriya S, Piratvisuth T. The value of Carlsson-dent questionnaire in diagnosis of gastroesophageal reflux disease in area with low prevalence of gastroesophageal reflux disease. J Neurogastroenterol Motil. 2011; 17(2): 164–8. DOI: https://doi.org/10.5056/jnm.2011.17.2.164
Nwokediuko S. Gastroesophageal reflux disease: a population based study. Gastroenterology Res. 2009;2(3):152–156. DOI: https://doi.org/10.4021/gr2009.05.1291
Sun XM, Tan JC, Zhu Y, Lin L. Association between diabetes mellitus and gastroesophageal reflux disease A meta-analysis. World J Gastroenterol. 2015; 21(10): 3085–92. DOI: https://doi.org/10.3748/wjg.v21.i10.3085
Ferreira-Hermosillo A, Molina-Ayala MA. Enfermedades autoinmunitarias asociadas a diabetes mellitus tipo 1A. Rev Medica Chile. 2015; 143(8): 1042–9. DOI: https://doi.org/10.4067/S0034-98872015000800012
Contreras-Omana R, Sanchez-Reyes O, Angeles-Granados E. Comparison of the Carlsson-Dent and GERD-Q questionnaires for gastroesophageal reflux disease symptom detection in a general population. Rev Gastroenterol Mexico. 2017; 82(1): 19–25. DOI: https://doi.org/10.1016/j.rgmxen.2016.12.003
Jones B, Ravich WJ. Establishing a comprehensive center for diagnosis and therapy of swallowing Disorders. In: Shaker R, Easterling C, Belafsky P, Postma G, editors. Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglution. Springer, New York, NY; 2013. pp. 3-10 DOI: https://doi.org/10.1007/978-1-4614-3779-6_1
Saragih RH, Rey I. FSSG scale system in comparison with GERD questionnaires in predicting endoscopic findings with reflux esophagitis. Indones J Gastroenterol Hepatol Dig Endosc. 2012; 14(3): 136–40.
Miyamoto M, Haruma K, Takeuchi K, Kuwabara M. Frequency scale for symptoms of gastroesophageal reflux disease predicts the need for addition of prokinetics to proton pump inhibitor therapy. J Gastroenterol Hepatol. 2008; 23(5): 746–51. DOI: https://doi.org/10.1111/j.1440-1746.2007.05218.x
Faria M, Pavin EJ, Parisi MC, Nagasako CK, Mesquita MA. Dyspeptic symptoms in patients with type 1 diabetes endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors. Arch Endocrinol Metab. 2015; 59(2): 129–36.. DOI: https://doi.org/10.1590/2359-3997000000025
Downloads
Accepted 2017-08-11
Published 2017-09-29
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use