Frequent Nighttime Symptoms and Increased GERD Symptom Severity Are Associated with Impaired Functioning: 883

Purpose: To assess health-related quality of life (HRQOL) among GERD patients stratified by symptom severity and by nighttime symptoms. Methods: A sample of US adults participated in a web survey including a validated GERD screener. Frequency and severity of nighttime and daytime heartburn and acid regurgitation during the previous 3 months were each assessed. The highest value reported for symptoms during the daytime or nighttime was assigned to assess severity (10-point Likert scale). Severity classification was: mild (1–4), moderate (5–7) and severe (8–10). Nighttime GERD (NTG) cases were defined as: (a) symptoms ≥2 nights/wk with or without daytime symptoms, or (b) cases without daytime symptoms but at least one night/wk with symptoms. SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) scores were calculated and mean scores were compared for NTG vs Daytime GERD (DTG) (t-tests), and by severity (ANOVA). Lower scores signify worse HRQOL. Results: 2,805 of 18,213 invited to participate responded. 2,603 (mean age = 46 years, 55% women) satisfied the study criteria. Among 668 cases with current GERD symptoms, 303 had NTG and 365 had DTG; 664 cases had severity data: 155 were mild, 341 moderate, and 168 severe. GERD cases with NTG had lower MCS and PCS scores compared with DTG cases (Table 1; P < 0.05). Among individuals with GERD, as GERD severity increased, MCS and PCS scores significantly decreased (Table 2; P < 0.05). Differences between moderate and severe groups were twice as large as differences between mild and moderate groups.Table 1: Mean MCS and PCS Scores for NTG vs DTGTable 2: Mean MCS and PCS Scores by GERD SeverityConclusion: HRQOL is significantly worse in patients with nighttime GERD symptoms. Symptom severity is also associated with decreased HRQOL. These findings suggest that even partial improvement in symptom severity or reduction in nighttime symptoms may lead to improved mental and physical functioning among symptomatic GERD patients.