Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2019; 7(12): 1421-1429
Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1421
Impact of gastroesophageal reflux disease on the quality of life of Polish patients
Rafał Gorczyca, Piotr Pardak, Anna Pękala, Rafał Filip
Rafał Gorczyca, Department of Clinical Endoscopy, Institute of Rural Health, Lublin 20-080, Poland
Piotr Pardak, Anna Pękala, Rafał Filip, Department of Gastroenterology with IBD Unit of Clinical Hospital 2, University of Rzeszów, Rzeszów 35-301, Poland
Author contributions: Gorczyca R and Filip R designed the study, performed the data collection and statistical analyses; Filip R, Pardak P and Pękala A performed data interpretation and drafted the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the Institutional Ethic Committee at the Institute of Rural Health in Lublin, Poland.
Informed consent statement: All patients gave their written informed consent prior to study inclusion.
Conflict-of-interest statement: There are no conflicts of interest to report for any of the authors.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Piotr Pardak, MD, Doctor, Department of Gastroenterology with IBD Unit of Clinical Hospital 2, University of Rzeszów, Lwowska 60, Rzeszów 35-301, Poland. piotrpardak@wp.pl
Telephone: +48-17-8664607 Fax: +48-17-8664702
Received: January 3, 2019
Peer-review started: January 3, 2019
First decision: January 30, 2019
Revised: April 22, 2019
Accepted: May 2, 2019
Article in press: May 2, 2019
Published online: June 26, 2019

Gastro-esophageal reflux disease (GERD) is a serious health and social problem leading to a considerable decrease in the quality of life of patients. Among the risk factors associated with reflux symptoms and that decrease the quality of life are stress, overweight and an increase in body weight. The concept of health-related quality of life (HRQL) covers an expanded effect of the disease on a patient’s wellbeing and daily activities and is one of the measures of widely understood quality of life. HRQL is commonly measured using a self-administered, disease-specific questionnaires.


To determine the effect of reflux symptoms, stress and body mass index (BMI) on the quality of life.


The study included 118 patients diagnosed with reflux disease who reported to an outpatient department of gastroenterology or a specialist hospital ward for planned diagnostic tests. Assessment of the level of reflux was based on the frequency of 5 typical of GERD symptoms. HRQL was measured by a 36-item Short Form Health Survey (SF-36) and level of stress using the 10-item Perceived Stress Scale. Multi-variable relationships were analyzed using multiple regression.


Eleven models of analysis were performed in which the scale of the SF-36 was included as an explained variable. In all models, the same set of explanatory variables: Gender, age, reflux symptoms, stress and BMI, were included. The frequency of GERD symptoms resulted in a decrease in patients’ results according to 6 out of 8 SF-36 scales- except for mental health and vitality scales. Stress resulted in a decrease in patient function in all domains measured using the SF-36. Age resulted in a decrease in physical function and in overall assessment of self-reported state of health. An increasing BMI exerted a negative effect on physical fitness and limitations in functioning resulting from this decrease.


In GERD patients, HRQL is negatively determined by the frequency of reflux symptoms and by stress, furthermore an increasing BMI and age decreases the level of physical function.

Keywords: Gastroesophageal reflux disease, Stress, Psychological factors, Health-related quality of life, Obesity

Core tip: Gastro-esophageal reflux disease is a serious health problem leading to a decrease in the quality of life. This study determines the effect of reflux symptoms, stress and body mass index (commonly known as BMI) on the quality of life measured by a 36-item Short Form Health Survey. We demonstrate that in patients with gastro-esophageal reflux, stress decreases the quality of life to a higher degree than the frequency of reflux symptoms. Age and increasing BMI result in decreased physical function. Therefore, the patient’s stress level should be considered in the diagnosis and therapy, as well as an assessment of the progress of treatment.