Lifestyle intervention for gastroesophageal reflux disease: a national multicenter survey of lifestyle factor effects on gastroesophageal reflux disease in China

Ling-Zhi Yuan; Ping Yi; Gang-Shi Wang; Shi-Yun Tan; Guang-Ming Huang; Ling-Zhi Qi; Yan Jia; Fen Wang

doi:10.1177/1756284819877788

Lifestyle intervention for gastroesophageal reflux disease: a national multicenter survey of lifestyle factor effects on gastroesophageal reflux disease in China

Therap Adv Gastroenterol. 2019 Sep 25:12:1756284819877788. doi: 10.1177/1756284819877788. eCollection 2019.

Authors

Ling-Zhi Yuan¹, Ping Yi¹, Gang-Shi Wang², Shi-Yun Tan³, Guang-Ming Huang⁴, Ling-Zhi Qi⁵, Yan Jia⁶, Fen Wang⁷

Affiliations

¹ Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
² Department of Gastroenterology, The General Hospital of Chinese People's Liberation Army, Beijing, China.
³ Department of Gastroenterology, The People's Hospital of Wuhan University, Hubei, China.
⁴ Department of Gastroenterology, The Second Affiliated Hospital of Nanjing Medical University, Jiangsu, China.
⁵ Department of Gastroenterology, The People's Hospital of Jilin Province, Changchun, China.
⁶ Department of Gastroenterology, Army General Hospital, Beijing, China.
⁷ Department of Gastroenterology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Changsha 410013, Hunan, China.

Abstract

Background: Poor habits can worsen gastroesophageal reflux disease (GERD) and reduce treatment efficacy. Few large-scale studies have examined lifestyle influences, particularly eating habits, on GERD in China, and research related to eating quickly, hyperphagia, and eating hot foods is quite limited. The aim of this study was to evaluate the relationship between GERD pathogenesis and lifestyle factors to produce useful information for the development of a clinical reference guide through a national multicenter survey in China.

Methods: Symptom and lifestyle/habit questionnaires included 19 items were designed. The questionnaire results were subjected to correlation analysis relative to GERD symptom onset. A standard proton pump inhibitor (PPI) was advised to correct patients with unhealthful lifestyle habits.

Results: A total of 1518 subjects (832 GERD, 686 non-GERD) enrolled from six Chinese hospitals completed symptom and lifestyle/habit questionnaires. The top lifestyle factors related to GERD were fast eating, eating beyond fullness, and preference for spicy food. Univariate analysis showed that 21 factors, including male gender, a supra-normal body mass index (BMI), smoking, drinking alcohol, fast eating, eating beyond fullness, eating very hot foods, and drinking soup, among others, were associated with GERD (p < 0.05). Logistic multivariate regression analysis revealed the following risk factors for GERD [with odds ratios (ORs)]: fast eating (4.058), eating beyond fullness (2.849), wearing girdles or corsets (2.187), eating very hot foods (1.811), high BMI (1.805), lying down soon after eating (1.544), and smoking (1.521). Adjuvant lifestyle interventions improved outcomes over medication alone (z = -8.578, p < 0.001 Mann-Whitney rank sum test).

Conclusions: Lifestyle interventions can improve medication efficacy in GERD patients. Numerous habits, including fast eating, eating beyond fullness, and eating very hot foods, were associated with GERD pathogenesis. The present results may be useful as a reference for preventive education and treatment.

Keywords: dietary habits; gastroesophageal reflux disease (GERD); hyperphagia; life style; therapeutics.