Association Between Dinner-to-Bed Time and GERD
Objective: It is generally recommended that patients with gastro-esophageal reflux disease (GERD) refrain from eating within 3 h of going to sleep. In addition to a remarkable lack of supporting clinical evidence, whether GERD patients have shorter dinner-to-bed time is unknown. This study was designed to determine a possible association between dinner-to-bed time and GERD, compared with healthy adults.
Methods: In a matched case-control study, we enrolled 147 GERD patients, and age- and sex-matched 294 controls without GERD symptoms such as heartburn and acid regurgitation during the previous year. Dinner-to-bed time, defined as the time intervals until going to bed after finishing eating dinner, was examined by a self-report questionnaire. Logistic regression was used to calculate odds ratio (OR) and 95% confidence intervals (CI) for GERD.
Results: After adjustment for smoking habits, drinking habits, and body mass index, shorter dinner-to-bed time was significantly associated with an increased OR of GERD (p< 0.0001) and the OR for patients whose dinner-to-bed time was less than 3 h was 7.45 (95% CI 3.38–16.4) compared with patients whose dinner-to-bed time was 4 h or more. These observations were consistent in both patients with nonerosive GERD and erosive esophagitis, and there was no significant difference in dinner-to-bed time intervals between nonerosive GERD and erosive esophagitis.
Conclusion: In this matched case-control study, shorter dinner-to-bed time was significantly associated with an increased OR for GERD.
Gastro-esophageal reflux disease (GERD) is the most common gastrointestinal disease and includes nonerosive GERD and erosive esophagitis. Epidemiological studies showed that prevalence of GERD ranges from 10% to 48% in Western countries and 6.6% to 9.8 % in Japan. Management of GERD includes lifestyle modification, pharmacological agents such as proton pump inhibitors, H2-blockers, prokinetics and antacids, endoluminal techniques, and antireflux surgery.
Numerous lifestyle modifications have been advocated to be important in GERD therapy. They include elevation of the head of the bed, cessation of smoking, and avoidance of particular foods and/or alcoholic drinks, which provoke GERD symptoms. These lifestyle changes may be of varying benefit to achieve satisfactory control of GERD symptoms, yet, it is important to educate the patients about these interventions because patients can then choose for themselves how to integrate them into their treatment plan. In the textbook and the guidelines from the American College of Gastroenterology, it is recommended that the patient refrain from eating within 3 h of going to sleep. In addition to a remarkable lack of clinical data about the efficacy of lifestyle modifications, whether patients with GERD have shorter time intervals until going to bed after finishing eating dinner is unknown. The present study was designed to examine a possible association between dinner-to-bed time and GERD by a matched case-control study.
Objective: It is generally recommended that patients with gastro-esophageal reflux disease (GERD) refrain from eating within 3 h of going to sleep. In addition to a remarkable lack of supporting clinical evidence, whether GERD patients have shorter dinner-to-bed time is unknown. This study was designed to determine a possible association between dinner-to-bed time and GERD, compared with healthy adults.
Methods: In a matched case-control study, we enrolled 147 GERD patients, and age- and sex-matched 294 controls without GERD symptoms such as heartburn and acid regurgitation during the previous year. Dinner-to-bed time, defined as the time intervals until going to bed after finishing eating dinner, was examined by a self-report questionnaire. Logistic regression was used to calculate odds ratio (OR) and 95% confidence intervals (CI) for GERD.
Results: After adjustment for smoking habits, drinking habits, and body mass index, shorter dinner-to-bed time was significantly associated with an increased OR of GERD (p< 0.0001) and the OR for patients whose dinner-to-bed time was less than 3 h was 7.45 (95% CI 3.38–16.4) compared with patients whose dinner-to-bed time was 4 h or more. These observations were consistent in both patients with nonerosive GERD and erosive esophagitis, and there was no significant difference in dinner-to-bed time intervals between nonerosive GERD and erosive esophagitis.
Conclusion: In this matched case-control study, shorter dinner-to-bed time was significantly associated with an increased OR for GERD.
Gastro-esophageal reflux disease (GERD) is the most common gastrointestinal disease and includes nonerosive GERD and erosive esophagitis. Epidemiological studies showed that prevalence of GERD ranges from 10% to 48% in Western countries and 6.6% to 9.8 % in Japan. Management of GERD includes lifestyle modification, pharmacological agents such as proton pump inhibitors, H2-blockers, prokinetics and antacids, endoluminal techniques, and antireflux surgery.
Numerous lifestyle modifications have been advocated to be important in GERD therapy. They include elevation of the head of the bed, cessation of smoking, and avoidance of particular foods and/or alcoholic drinks, which provoke GERD symptoms. These lifestyle changes may be of varying benefit to achieve satisfactory control of GERD symptoms, yet, it is important to educate the patients about these interventions because patients can then choose for themselves how to integrate them into their treatment plan. In the textbook and the guidelines from the American College of Gastroenterology, it is recommended that the patient refrain from eating within 3 h of going to sleep. In addition to a remarkable lack of clinical data about the efficacy of lifestyle modifications, whether patients with GERD have shorter time intervals until going to bed after finishing eating dinner is unknown. The present study was designed to examine a possible association between dinner-to-bed time and GERD by a matched case-control study.
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