Definition of nocturnal gastroesophageal reflux for studies on respiratory diseases.

Össur Ingi Emilsson, Bryndís Benediktsdóttir, Ísleifur Ólafsson, Elizabeth Cook, Sigurður Júlíusson, Sören Berg, Leif Nordang, Einar Stefán Björnsson, Sunna Guðlaugsdóttir, Anna Soffía Guðmundsdóttir, Christer Janson, Thorarinn Gislason

Research output: Contribution to journalArticlepeer-review


Objective Nocturnal gastroesophageal reflux (nGER) has been associated with respiratory diseases. Our aim was to study a questionnaire method to identify nGER subjects with respiratory involvement in a general population. Material and methods A subgroup of Icelandic participants in the European Community Respiratory Health Survey III (ECRHS III) reporting symptoms of nGER (n = 48) as well as age and gender paired controls (n = 42) were studied further by a structured interview, questionnaires, laryngeal fibrescopy, and exhaled breath condensate. A subgroup underwent 24-h oesophageal pH impedance (24-h MII-pH) measurements. Symptoms of nGER were assessed with a modified version of the reflux disease questionnaire (RDQ), where symptoms were divided into daytime and nocturnal. A report of nGER both at baseline and at follow-up was defined as persistent nGER. Results Participants reporting persistent nGER had significantly more signs of laryngopharyngeal reflux according to the reflux finding score than those without nGER (Mean ± SD: 5.1 ± 2.3 vs. 3.9 ± 2.2, p = 0.02). Of the 16 persistent nGER subjects that underwent 24-h MII-pH, 11 had abnormal gastroesophageal reflux, but none of three control subjects (69% vs. 0%). Pepsin was more commonly found in exhaled breath condensate in the nGER group (67% vs. 45%, p = 0.04). Conclusions Participants with nGER symptoms at least once a month, reported on two occasions, had a high level of positive 24-h MII-pH measurements, laryngeal inflammation and pepsin in exhaled breath condensate. This nGER definition identified a representable group for studies on nGER and respiratory diseases in a general population.
Original languageEnglish
Pages (from-to)524-530
JournalScandinavian Journal of Gastroenterology
Issue number5
Publication statusPublished - 2016

Subject classification (UKÄ)

  • Gastroenterology and Hepatology


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