Compounding the problem is the inability of many GERD sufferers to find fast and effective relief from their symptoms. We know that the condition is exacerbated by fatty, acidic foods; coffee; chocolate; and alcohol. But there is so much that we don’t know: Just how common is it? Is it getting worse, and is that linked to the nation’s obesity epidemic? Are some ethnic and demographic groups more likely to have it, and are some also more difficult to treat? And why don’t current treatments work better? My colleagues and I at the Cedars-Sinai Center for Outcomes Research and Education and the University of Michigan in Ann Arbor set out to get some answers, or at least point ourselves in the right direction. We were able to plan and carry out the largest survey of its kind — a nationally representative sample of more than 71,000 adults, and we presented our findings at Digestive Disease Week (DDW) 2019 in San Diego. Our survey found that about 44 percent of Americans have acid reflux, and of those, 70 percent reported having symptoms within the past week. Among the one-third of people with GERD who are taking medicines, 54 percent of those using the most common treatment, known as proton pump inhibitors (PPI), said that it routinely fails to help them feel better. This is a particularly widespread problem because PPIs are more commonly used to treat GERD than all other methods, such as antacids and H2 receptor blockers, put together. Given the huge impact that GERD has on people’s lives, our survey dramatized the need to find new therapies and explore the specific populations for whom the current attempted therapies are not working. Specifically, we have to learn why PPIs are not providing relief and figure out a new treatment. Partnering with a survey research firm called Cint, we used MyGiHealth, a mobile app with an algorithm called AEGIS that led participants through a National Institutes of Health GI health questionnaire. Thanks to the app, we were able to quickly gather a large amount of data on how often GERD symptoms were felt, as well as information on comorbidities, medicine use, and demographics. We found the highest rate of GERD among older, non-Hispanic, married, more educated women who also had comorbidities such as Crohn’s disease, endometriosis, and thyroid ailments. We also noted that the highest failure rate among those who tried PPIs to ease their symptoms was for those who were younger, female, Latino, married, employed, and had irritable bowel syndrome. In many ways, our study, which was supported by Ironwood Pharmaceuticals of Massachusetts, has raised more questions than it answered. We need to figure out why various populations have higher rates of GERD, and find out what causes certain populations to benefit from PPIs or not. We hope our future efforts will lead us to find treatments that work better for a huge population that badly needs them.
