GASTROESOPHAGEAL REFLUX DISEASE AND QUALITY OF LIFE

• DOI: https://doi.org/10.22533/at.ed.1594922414109

• Palavras-chave: Gastroesophageal reflux disease; quality of life

• Keywords: Gastroesophageal reflux disease; quality of life

• Abstract: Background: Gastroesophageal reflux (GER) is defined as the spontaneous passive return of gastric content to the esophagus, regardless of its etiology. When not associated with diseases or complications, it is termed physiological GER. However, when associated with signs and symptoms, it characterizes gastroesophageal reflux disease (GERD), the most common organic disorder of the digestive tract. GERD is defined as a chronic condition resulting from the retrograde flow of gastroduodenal content into the esophagus and/or adjacent organs, leading to a variable spectrum of esophageal and/or extra-esophageal symptoms and/or signs, associated or not with tissue damage. This condition can significantly impair the patient's quality of life (QOL) and interfere with their lifestyle habits. The primary diagnostic method in suspected GERD is upper gastrointestinal endoscopy (UGIE), which also assesses the presence and degree of esophagitis. Typical manifestations (heartburn and regurgitation) predominate, with only 15% to 20% of cases exhibiting predominantly atypical symptoms. Objective: To analyze the individual repercussions of this condition on QOL, considering the intensity of endoscopic and anatomopathological manifestations. Method: A prospective observational study of consecutive cases of GERD at the Barretos Specialized Outpatient Facility (AME Barretos). Patients referred for endoscopic investigation due to clinical suspicion of the disease were subjected to a questionnaire related to specific symptoms for identification and assessment of the impact of GERD symptoms (Gastroesophageal Reflux Disease Symptom Questionnaire - QS-GERD and Gastroesophageal Reflux Disease Health-Related Quality of Life, validated in Portuguese - GERD-HRQL). The questionnaire was administered to patients after recovery from the anesthesia sedation of upper gastrointestinal endoscopy (UGIE). Results: Data were collected from 123 (patients undergoing gastroscopy with a diagnosis of GERD. The majority of patients were of white ethnicity (67.5%) and female gender (63.4%). The most prevalent symptoms were epigastric pain (90.2%), epigastric burning (90.2%), and regurgitation (75.6%). Regarding the duration of the disease, the majority presented symptoms for less than 1 year (41.5%), with a predominance of proton pump inhibitor (PPI) use for symptom relief (Omeprazole - 76.4% and Pantoprazole - 61.8%). Concerning the relationship between GERD and interference with QOL, 90.2% reported dissatisfaction, and almost all patients (90%) used some medication for symptom control. However, around half of the patients (57.7%) did not report difficulty in performing their daily activities. Conclusion: The study shows the evident prevalence of typical GERD symptoms in the evaluated population. When analyzing therapeutic measures, as expected, there is a high proportion of PPI use. The assessment of the impact on QOL demonstrates overall dissatisfaction when analyzing symptomatic repercussions but shows a moderate impact on daily life and work interference. Thus, it can be concluded that GERD is not incapacitating; however, it causes generally acute symptoms that interfere considerably with the patient's QOL.