Predictors of diagnosis and symptom perception in GORD/LPR
Research type
Research Study
Full title
Psychological predictors of diagnosis and symptom perception in gastro-oesophageal and laryngo-pharyngeal reflux disease
IRAS ID
118530
Contact name
Robert Horne
Contact email
Sponsor organisation
University College London
Research summary
Gastro-oesophageal reflux disease (GORD) and laryngo-pharyngeal reflux disease (LPR) are caused by an increase in acid within the gullet. Some individuals, however, experience GORD and LPR-like symptoms in the absence of abnormal pH. Patients who do experience symptoms, such as heartburn due to abnormal pH within the gullet, and respond to treatment are termed true responders. Those who experience symptoms due to normal changes in pH are termed hypersensitive, whereas others who experience symptoms that do not relate to normal changes in pH are considered to have functional heartburn. Hypersensitive patients and those with functional heartburn seem to respond less well to current medication.
The present study aims to predict whether patients are true responders, hypersensitive patients and functional heartburn patients, as assessed using self-reported symptoms and a 24-hour impedance-pH test, using a number of psychological predictors. Secondly, the study aims to assess whether these subgroups of patients differ in their response to different messages about treatment effectiveness, as assessed through a modified Bernstein Test. In this test, two saline solutions will be perfused consecutively in the gullet, however, different information will be provided about each solution (beneficial or neutral).
Logistic regression will be used to determine whether differences in psychological variables predict diagnosis test outcome. Regression analysis will be used to determine relationships between psychological variables and 1) pain perception during the modified Bernstein test, 2) reported benefit from current PPI treatment.
Results from this study may inform the diagnostic process, allow doctors to make quicker decisions about treatment and identify those patients who may benefit more from alternative therapies such as cognitive behavioural therapy.
REC name
London - Queen Square Research Ethics Committee
REC reference
14/LO/0593
Date of REC Opinion
22 May 2014
REC opinion
Further Information Favourable Opinion