Relationship between gastroesophageal reflux disease (GERD) and constipation: laxative use is common in GERD patients
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ORIGINAL ARTICLE
Relationship between gastroesophageal reflux disease (GERD) and constipation: laxative use is common in GERD patients Eri Momma1 · Mai Koeda1 · Tomohide Tanabe1 · Yoshimasa Hoshikawa1 · Shintaro Hoshino1 · Noriyuki Kawami1 · Tetsuro Kawagoe1 · Atsushi Tatsuguchi1 · Mitsuru Kaise1 · Katsuhiko Iwakiri1 Received: 22 June 2020 / Accepted: 14 August 2020 © The Japan Esophageal Society 2020
Abstract Background The relationship between gastroesophageal reflux disease (GERD) and constipation has not yet been examined in Japan. We herein analyzed the use of laxatives by GERD and non-GERD patients to clarify the relationship between GERD and constipation. Methods This was a retrospective observational study designed to examine the use of laxatives by GERD and non-GERD patients. A total of 118 patients (mean age 69.7 years, 50 males) with reflux esophagitis (RE) and non-erosive reflux disease (NERD) who received maintenance acid-suppressive therapy for more than 1 year were included in the GERD group (83 RE patients, 35NERD patients). Similarly, 61 patients (mean age 69.4 years, 28 males) who received regular acid-suppressive therapy for reasons other than GERD were included in the non-GERD group. We also investigated demographic factors associated with the onset of GERD, including body mass index (BMI), age, and sex. Results The frequency of laxative use was significantly higher in the GERD group (38.1%) than in the non-GERD group (21.3%). No significant differences were observed in dose frequencies between the groups. The type of laxative used also did not significantly differ between the groups. Furthermore, no significant differences were noted in sex, age, or BMI between the groups. Conclusions The use of laxatives was significantly more common in GERD patients than in non-GERD patients. The present results suggest that a relationship exists between GERD and constipation. Keywords Gastroesophageal reflux disease · Constipation · Laxative
Introduction The Japanese Society of Gastroenterology guidelines for the diagnosis of gastroesophageal reflux disease (GERD) strongly recommend the use of proton pump inhibitors (PPIs) as the first-line approach for both initial and maintenance therapies [1]. Since the risk of recurrence is high, GERD patients often receive continuous maintenance therapy [1]. GERD patients who are regularly followed up as outpatients often exhibit recurrent symptoms of reflux, such as temporary heartburn. The guidelines propose the addition of prokinetic agents or Japanese herbal medicine (Kampo) to * Katsuhiko Iwakiri k‑[email protected] 1
Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1‑1‑5, Sendagi, Bunkyo‑ku, Tokyo 113‑8603, Japan
the treatment regimen for these patients [1]. At our hospital, GERD outpatients are asked every time about their bowel movement. Interview results revealed that some patients who present with worsening symptoms of reflux have abdominal distention due to constipation. Furthermore, as constipation resolves, reflu
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