37
Abstracts
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Gastroenterology
Concurrent Conditions in Patients With Chronic
Constipation: A Population-based Study
Arora G, et al
PLoS One
. 2012;7(10):e42910.
Chronic constipation (CC) is a common condition but
its concurrent conditions are not well characterized. We
measured the prevalence and risk of developing 15 pre-
specified concurrent conditions in patients with CC.
This is a retrospective cohort study using the Medicaid
database of California, utilizing ICD-9 codes for detection
of cases (CC), controls (patients with GERD) and
concurrent conditions. Index date was the date, 3 months
before the first physician visit for CC. Pre-index time (12
months) was compared to post-index time (12 months) to
assess the association of every concurrent condition within
each cohort.
In this study, 147,595 patients with CC (mean age =
54.2 years; 69.7% women; 36.2% white) and 142,086
patients with GERD (mean age = 56.3 years; 65.3%
women; 41.6% white) were evaluated. The most prevalent
concurrent conditions with CC were hemorrhoids (7.6%),
diverticular disease (5.9%), anorectal hemorrhage (4.7%),
irritable bowel syndrome (3.5%) and fecal impaction (2%).
When adjusted for ascertainment bias, the most notable
associations with CC were Hirschsprung disease, fecal
impaction, and anorectal conditions such as fissure, fistula,
hemorrhage, and ulcers.
Chronic constipation is associated with several concurrent
conditions of variable risk and prevalence. To reduce the
overall burden of CC, these concurrent conditions need to
be addressed.
The Association Between Reflux Esophagitis
and Airway Hyper-reactivity in Patients With
Gastro-esophageal Reflux
Karbasi A, et al
J Res Med Sci
. 2013;18(6):473–476.
The association of gastroesophageal reflux (GER) with a
wide variety of pulmonary disorders was recognized. We
aimed to evaluate the effect of GER-induced esophagitis on
airway hyperreactivity (AHR) in patients and the response
to treatment.
In this cohort study, 30 patients attending the
gastrointestinal clinic of a university hospital with acid
reflux symptoms were included. All patients were evaluated
endoscopically and divided into case group with esophagitis
and control group without any evidence of esophagitis.
Spirometry and methacholine test were done in all patients
before and after treatment of GER for 6 months.
There was a significant difference in the rate of positive
methacholine test between the cases (40%) and the
controls (6.7%) prior to anti-acid therapy (
P
< .0001).
After 6 months of treatment, the frequency of positive
methacholine test diminished from 40% to 13.3% in the
case group (
P
< .05) but did not change in the controls
(
P
= .15).
The presence of esophagitis due to GER would increase the
AHR and treatment with anti-acid therapy would decrease
AHR in patients with proved esophagitis and no previous
history of asthma after 6 months.
