Are GERD and FD cousin disease? The impact of GERD/EPS/PDS symptoms on patients' living status and QOL, and the efficacy of PPI treatment on each symptom.

In primary care clinic, GERD and functional dyspepsia (FD) are frequently accompanied. This may enhances the impairment of patients' daily life.
AIMS: To study the impact of GERD/EPS/PDS symptoms (Sx) on patients' daily life, and the efficacy of PPI treatment on each Sx.
METHODS: The GERD patients who met the Montreal definition were recruited. Upper gastrointestinal endoscopy was performed before 4 weeks-PPI treatment. GERD and FD Sx, dissatisfaction causing in Sx, and patient-reported treatment efficacy were evaluated using a newly developed questionnaire, GERD-TEST. Psychological tendency and generic QOL were also assessed using HADS and SF-8. Multiple regression analysis was conducted to examine the impact of each Sx on living status, HADS scores and SF-8 (PCS, MCS). The therapeutic efficacy of 4-weeks PPI treatment for each Sx were also examined.
RESULTS: 289 patients were eligible for analysis. 83% of GERD patients were concomitant with FD-Sx (EPS-Sx and/or PDS-Sx). In multiple regression analysis, higher (more severe) GERD-subscale (SS) correlated with stronger dissatisfaction about sleep, daily activity and mood. On the other hand, higher EPS-Sx correlated with lower SF-8 PCS and MCS, higher HADS anxiety, and stronger dissatisfaction about diet, sleep, daily activity and mood, and higher PDS-SS correlated with lower SF-8 MCS, higher HADS anxiety and depression, and stronger dissatisfaction about diet, daily activity and mood (β=0.646-0.127, p<0.001-0.047). In 98 patients with all of GERD/EPS/PDS-Sx, 4-weeks PPI treatment was effective for all Sx with large effect size (Cohen' d were 1.43, 1.43 and 1.27, respectively).
CONCLUSIONS: FD-Sx have a broader and stronger effect than GERD-Sx on daily life of the patients. 4-weeks PPI treatment was effective for all of GERD/EPS/PDS-Sx.