Gastroesophageal Reflux Disease Questionnaire (GerdQ) in Real-world Practice

Yu Bai; Yiqi Du; Duowu Zou; Zhendong Jin; Xianbao Zhan; Zhao-Shen Li; Yunsheng Yang; Yulan Liu; Shutian Zhang; Jiaming Qian; Liya Zhou; Jianyu Hao; Dongfeng Chen; Dianchun Fang; Daiming Fan; Xiaofeng Yu; Weihong Sha; Yuqiang Nie; Xiaofeng Zhang; Hong Xu; Nonghua Lv; Bo Jiang; Xiaoping Zou; Jingyuan Fang; Jiangao Fan; Yan Li; Weichang Chen; Bangmao Wang; Yiyou Zou; Youming Li; Mingjun Sun; Qikui Chen; Minhu Chen; Xiaoyan Zhao

Disclosures

J Gastroenterol Hepatol. 2013;28(4):626-631. 

In This Article

Abstract and Introduction

Abstract

Background and Aim: Recently, Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed for diagnosis of GERD. However, no study investigated its value in real-world practice. This study aimed to investigate whether GerdQ can be used for diagnosis of GERD in China.

Methods: A national multicenter survey was undertaken; all patients who underwent first diagnostic upper endoscopy for upper gastrointestinal (GI) symptoms were included. Data including the gender, age, symptoms, and endoscopic findings were prospectively recorded. The GerdQ score was measured before endoscopic procedure.

Results: Totally, 8065 patients were included. One thousand four hundred and thirty-five patients (17.8%) had reflux esophagitis. Among them, 620 (43.2%) patients' GerdQ score was ≥ 8. For 2025 patients with GerdQ ≥ 8, 620 (30.6%) were found to have reflux esophagitis, but the remaining 69.4% (1405/2025) were normal. Proportions of patients with reflux esophagitis increased in cut-off range from 3–18 for GerdQ. However, 22.2% of the patients with a GerdQ score ≤ 2 also had reflux esophagitis. Twenty-eight (0.3%) patients were diagnosed to have upper GI malignancies, and 10 out of these 28 (35.7%) patients' GerdQ score was ≥ 8.

Conclusions: The study suggests the proportions of Chinese patients with reflux esophagitis rise up with the increase of GerdQ score, and GerdQ may be used for diagnosis of GERD. However, low GerdQ score cannot exclude the possibility of reflux esophagitis. A minority of Chinese patients has high GerdQ score but is diagnosed with malignancies, even in the absence of alarm features.

Introduction

Gastroesophageal Reflux Disease (GERD) is considered as one of the most common digestive diseases in the world, and about 25–30% of the Western population reported reflux-related symptoms.[1] However, as there is no single test has a high-accuracy rate for diagnosing GERD, even endoscopy or pH monitoring alone cannot identify all patients with GERD, in view of this, current guidelines recommend making a clinical diagnosis of GERD based on the presence of most troublesome symptoms of heartburn and regurgitation.[2,3] It is supposed that the prevalence of GERD is believed to be less in the Chinese population, among whom heartburn and regurgitation occurred monthly or more in 9.3% of population according to a Hong Kong survey.[4] As the Chinese economic development has been occurring for more than 30 years, and the lifestyle and dietary habits of the Chinese have been gradually changed to be more Western, it is reported the prevalence of GERD may have been increasing in China.[5]

Recently, the Gastroesophageal Reflux Disease Questionnaire (GerdQ) has been developed, and it is shown the GerdQ, family practitioners and gastroenterologists have moderate and similar accuracy for diagnosis of GERD.[6,7] Though GerdQ may be useful, first, it has not been widely applied in non-Western countries, second, the Diamond study is an international multicenter study, but a large number of drop-outs occurred,[7] possibly because of the lengthy evaluation process. Therefore, its value in the evaluation of patients with possible GERD in clinical practice has never been investigated in a larger study, and whether GerdQ can be used for the diagnosis of GERD in China is yet to be determined. To address these issues, a national multicenter survey was conducted to determine the clinical value of GerdQ in Chinese patients.

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