Observational studyWorld journal of gastroenterology2025
Clinical characteristics and risk factors of refractory gastroesophageal reflux disease: A multicenter cross-sectional study.
Observational study in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Beyond monotherapy by acid suppression: Reshaping the management of refractory gastroesophageal reflux disease.World journal of gastroenterology · 2026Article
- Efficacy and safety of endoscopic cardia constriction ligation with a single-use endoscope versus a reusable endoscope for refractory gastroesophageal reflux disease: protocol for a multicenter randomized controlled trial.Frontiers in medicine · 2026Article
- Reflux esophagitis patients exhibit reduced gastric tolerance, impaired slow-wave activity and esophageal dysmotility.Frontiers in medicine · 2026Article
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32 authors.
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Abstract
backgroundRefractory gastroesophageal reflux disease (GERD) constitutes a significant proportion of GERD cases and presents a considerable burden in clinical practice. However, the underlying risk factors contributing to persistent and refractory symptoms and the clinical characteristics of this disease remain poorly understood.
aimTo investigate the clinical features of refractory GERD and identify the associated risk factors.
methodsThis is a multicenter cross-sectional study on patients with GERD across 18 medical centers in Shanghai. All participants completed comprehensive questionnaires that assessed their demographic characteristics, lifestyle and dietary habits, clinical manifestations, somatic symptoms, mental and psychological health status, and quality of life. Univariate analysis was performed to identify significant differences between the patients with refractory and non-refractory GERD. Subsequently, stepwise regression analysis was employed to conduct a multivariate binary logistic regression for exploring the association between refractory GERD and various factors, including dietary habits, lifestyle, clinical symptoms, and mental and psychological status.
resultsOur study included 911 patients diagnosed with GERD, of whom 256 (28.1%) had refractory GERD and 655 (71.9%) had non-refractory GERD. Compared to patients with non-refractory GERD, those with refractory GERD are older, have a longer disease duration, and exhibit higher scores for typical reflux symptoms. They are also more likely to present with atypical symptoms, more prone to overeating, more likely to experience somatic symptoms, comorbid anxiety, and depression, and report a lower quality of life. Binary logistic regression analysis identified disease duration and anxiety as significant risk factors and at least 90 minutes of moderate-intensity physical activity per week as a protective factor for refractory GERD.
conclusionRefractory GERD is associated with a prolonged disease duration, anxiety status, and insufficient physical activity. These findings may afford valuable insights for the clinical management and development of non-pharmacological interventions for refractory GERD.
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