Analysis of Psychological and Gut Microbiome Characteristics in Patients With Non-erosive Reflux Disease

Objective: To assess the correlation between the incidence of non-erosive reflux disease (NERD) and psychological factors, especially somatoform disorders. To investigate the characteristics of gut microbiome in NERD patients.Methods: We enrolled 24 NERD patients and 24 healthy controls. All patients were evaluated via GerdQ, SOMS-7, SAS, HAMA, and HAMD. Fecal samples were collected and 16S rRNA sequencing was performed to evaluate the gut microbiome composition.Results: The main symptoms of the NERD patients were regurgitation (87.5%), belching (66.7%), pharyngeal discomfort (50%), and heartburn (37.5%). The average score of GerdQ was 13.42 ± 3.41. In 15 patients (62.5%), the total score of the last two items was <3 points, while the average score of 24 patients was 3.63 ± 2.32. NERD patients with somatoform disorders accounted for 50%. There were 17 patients without anxiety, 6 patients with mild anxiety (25%), 1 patient with moderate anxiety (4.2%), and no patient with severe anxiety. There were 22 patients (91.7%) without depression, 2 patients (8.3%) with mild depression, and no patient with moderate or severe depression. The alpha diversity of NERD group was higher than HC, which showed significant difference (P < 0.05). The beta-diversity was significantly different between HC and NERD patients (P = 0.026), male and female patients (P = 0.009). The beta-diversity was also significantly different between male and female patients (P = 0.009). There were several bacteria with significant differences between HC and NERD group, and NERD patients with or without somatoform disorders, such as Firmicutes, TM7 were enriched in the NERD group compared with the healthy control group, while Bacteroidetes were enriched in the healthy controls.Conclusions: NERD symptoms overlap with somatoform disorders. NERD symptoms have an impact on the daily life quality of patients. Some of them are accompanied by anxiety and depression of different degrees, and the two are significantly correlated. The diversity of gut microbiome in patients with NERD is significantly higher than healthy controls, which has its characteristics. The predominant bacteria in gut microbiome of patients with NERD are similar to the healthy population, with Firmicutes and Bacteroidetes as the main ones. The composition of gut microbiome in NERD patients with or without somatoform disorder is significantly different, which may be related to the interaction of microbiome-brain-gut axis.

The prevalence and habit-associated risk factors of gastroesophageal reflux disease among fishermen in Indonesia

Background. This study was aimed to investigate the prevalence and habit-associated risk factors of gastroesophageal reflux disease (GERD) among fishermen.Methods. A cross-sectional study was conducted among 168 adult fishermen in Cirebon Regency, West Java, Indonesia. A self-administered questionnaire was given. The questionnaire consisted of demographic characteristics and validated GERD questionnaire (GERDQ) in Indonesian language. Data were analyzed using descriptive statistics and chi-square test. The study has been approved by the Medical Research Ethic Comiittee.Results. The medan age of the participants was 39.0 (24-86) years old. They were predominanty (60.7%) female. The prevalence of GERD was 22.6%. According to bivariate analysis, there was association between smoking (PR 1.181; 95%CI 1.013-1.377;p 0.041), high-salt intake (PR 2.419;95%CI 1.079-5.424; p 0.029), herb consumption (PR 3.068; 95%CI 1.307-7.200; p 0.008), poor hand hygiene (PR 3.202; 95%ci 1.445-7.095; p 0.003), and non-steroidal anti-inflammatory drug (NSAID) consumption (PR 3.062; 95%CI 1.446-6.488; p 0.00) with GERD. Tea consumption, coffee consumption, and raw vegetable eating were not associated with GERD.Conclusions This population-based study showed that the prevalence of GERD among fishermen in Indonesia is high. Habits associated with GERD in this study were smoking, high-salt intake, herb consumption poor, hand hygiene,

The relationship between white tongue and gastroesophageal reflux disease

Background Signs of gastroesophageal reflux disease (GERD) are limited, therefore, follow up of treatment are mainly based on patients’ symptoms. The aims of study were: 1) to compare the prevalence of white tongue (WT) between individuals with GERD and control group, 2) to evaluate the correlation between WT extension and severity of symptoms in GERD. Materials and methods This case-control study consisted of 100 consecutive individuals with GERD who were referred to the gastroenterology clinic of a referral hospital during 2019-2020. The diagnosis of GERD was made by a gastroenterologist if heart burn or regurgitation existed. The same number of healthy accompanies of patients without GERD participated as the control group. A single examiner defined WT if whitish-gray discoloration of tongue surface existed in two separate sessions [Kappa = 0.93; p < 0.01]. WT extension was estimated based on the approximate white discoloration of the tongue surface. Results All participants with GERD showed white tongue in the first observation and 98% in the second observation, while only 5% of the individuals in the control group revealed WT in both observations (p < 0.001). There was a positive correlation between the WT extension and GERD symptom severity (r: 0.44; p < 0.001). Conclusion It seems that WT might be a reliable sign of GERD. Considering the association between GERD symptoms severity and the extent of WT in this observation, further studies may assess the utility of WT extension as a reasonable objective in monitoring treatment response.