Prevalence of dysphagia in patients with gastroesophageal reflux in Germany.

Dysphagia is an alarming symptom that raises the possibility of stricture or malignancy. This study compares the prevalence and severity of dysphagia symptoms in subjects with or without gastroesophageal reflux (GERD). In a population-based study, 500 residents of Cologne between the ages of 20 and 90 years [232 (46%) males and 268 (54%) females] were randomly selected from the city register and sent questionnaires with reflux-related questions. Two hundred sixty-eight replies (54%) were accepted into the study. Of these, 45% were men with a median age of 58 years. The median female age was 54 years. Thirty-four percent of the respondents (n=92) admitted having heartburn symptoms. There was no significant gender-based difference. There was little variation in reflux frequency between individual age groups. Twenty-three (25%) of the 92 respondents with reflux reported symptoms more than twice per week. Forty-five percent of this "reflux" group took medications for their heartburn. Swallowing difficulties, predominantly mild, were reported in 11.3% of the respondents. Dysphagia was significantly increased in the reflux group (28%) versus the normal group (3%) (p<0.001). Sixteen percent of respondents with mild and 65% of those with moderate to severe reflux symptoms reported additional dysphagia symptoms (p<0.001). Swallowing problems are common in patients with GERD. Approximately two thirds of patients with long-term and severe reflux symptoms also have dysphagia symptoms. Dysphagia should always be investigated by a physician.