Concomitant functional dyspepsia and irritable bowel syndrome decrease health-related quality of life in gastroesophageal reflux disease

Objective. Previous studies have reported an overlap between gastroesophageal reflux symptoms, functional dyspepsia ( FD) and irritable bowel syndrome ( IBS). The aim of this study was to investigate the prevalence of FD and IBS in gastroesophageal reflux disease ( GERD) and the effect on health-related quality of life ( HRQoL). Material and methods. FD and IBS prevalence and HRQoL were assessed by means of questionnaires in 215 referred and 48 non-referred ( non-care-seeking) GERD patients, proven with 24-h pH-metry. HRQoL in 131 matched controls was used for comparison. Results. In this group of GERD patients 25% had FD ( Dutch general population 13 - 14%), 35% had IBS ( Dutch general population 0.6 - 6%) and 5% had both FD and IBS. Only 35% had neither FD nor IBS. Among referred GERD patients, the prevalence of FD and IBS was higher ( p = 0.002 versus non-referred). Compared with controls, GERD patients without FD/IBS had lower HRQoL scores on only one of the nine SF-36 subscales (p <= 0.001); GERD + FD patients had lower scores on six subscales (p <= 0.0005); GERD + IBS patients had lower scores on eight subscales (p < 0.0005) and GERD + FD + IBS patients had lower scores on seven subscales (p <= 0.001). Compared with patients with GERD only, GERD + FD patients had lower scores on five subscales (p <= 0.001); GERD + IBS patients had lower scores on eight subscales (p < 0.0005) and GERD + FD + IBS patients had lower scores on six subscales (p <= 0.001). Conclusions. In patients with proven GERD, FD and IBS are more prevalent than in the general population. This prevalence is higher among care-seeking GERD patients. Only those GERD patients with concomitant FD/IBS have a much lower HRQoL. This suggests that in GERD, when properly treated, HRQoL is affected mainly by concomitant functional disorders and not by GERD itself.