Gastroesophageal reflux disease in patients with spinal cord injury.

Due to certain risk factors that pertain to patients with spinal cord injury (SCI), the prevalence and severity of gastroesophageal reflux disease (GERD) may be greater among patients with SCI than the general population. In this retrospective study, the prevalence of GERD in patients with SCI as compared with age- and sex-matched controls, using pharmacy data from a large health care system, and the adequacy of the diagnostic evaluation process are evaluated and the symptom and disease severity in patients with SCI who were treated for GERD are assessed. The findings show a 22% prevalence of GERD in patients with SCI versus 28% in General Medicine Clinic controls. Although the symptom severity is similar in patients with SCI and controls, patients with SCI who have GERD symptoms undergo endoscopy less frequently. Disturbingly, the prevalence of severe, stage IV esophagitis among patients with SCI is higher than controls (p = .03). These results should alert clinicians caring for patients with SCI to more aggressively evaluate and treat such patients with reflux symptoms of heartburn and regurgitation before the development of complications.