Sex- and gender-specific differences in symptoms and health-related quality of life among patients with gastroesophageal reflux disease

Gastroesophageal Reflux Disease (GERD) is a common chronic gastrointestinal disorder affecting both men and women. Nonerosive reflux disease generally affects more women, whereas GERD complications such as Barrett's esophagus (BE) or esophageal cancer affect more men. The aim of this study was to evaluate sex- and gender-specific symptoms and health-related quality of life (HRQoL) among men and women with GERD. Patients with clinical signs of reflux and completion of 24-hour pH-Impedance testing at the University Hospital Cologne were included into the study. Evaluation of symptoms and HRQoL included the following validated questionnaires: GERD-Health-Related Quality of Life (GERD HRQL), Gastrointestinal Quality of Life Index (GIQLI), and Hospital Anxiety and Depression Scale (HADS). In all, 509 women and 355 men with GERD were included. Men had a significantly higher DeMeester score (60.2 +/- 62.6 vs. 43 +/- 49.3, P < 0.001) and a higher incidence of BE (18.6 vs. 11.2%, P = 0.006). Women demonstrated significantly higher levels of anxiety (30.9 vs. 14.5%, P = 0.001), more severely impacting symptoms (45.3 +/- 11.3 vs. 49.9 +/- 12.3, P < 0.001), as well as physical (14.2 +/- 5.7 vs. 16.7 +/- 5.6, P < 0.001) and social dysfunction (13.3 +/- 4.8 vs. 14.8 +/- 4.3, P = 0.002). Women further reported a lower HRQoL (85.3 +/- 22.7 vs. 92.9 +/- 20.8, P < 0.001). Men and women differ on biological, psychological, and sociocultural levels.