Zhang N, Wang Y, Fang SS, Han M, Zheng QW, Zhu YY, Zhang MY, Li JJ, Cui LX, Tian JL, Deng YH, Zhu SL, Ni HM, Zhou L, Zuo GL, Huang TS, Liao Q, Li XQ, Shang YY, Wang YJ, Tian Y, Ge LY, Han HQ, Hu WM, Jiang Y, Li YJ, Mao X, Yang LH, Yao JM, Zheng X, Wang HW, Fang SQ. Clinical characteristics and risk factors of refractory gastroesophageal reflux disease: A multicenter cross-sectional study. World J Gastroenterol 2025; 31(45): 113060 [PMID: 41378325 DOI: 10.3748/wjg.v31.i45.113060]
Reader's ID:
08549003
Submitted on:
December 11, 2025, 18:40
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Reader Comments:
I want to congratulate the authors, Zhang et al, for conducting a study and identifying the predictors of refractory GERD. They have identified the disease duration and anxiety as significant risk factors and at least 90 minutes of moderate-intensity physical activity per week as a protective factor for refractory GERD. One of the important findings in this study is the association of significant Overlap DGBI symptoms (such as dyspepsia, constipation, and diarrhoea) in at least 50% of GERD patients. Since most patients had a duration of illness of more than 4 years, complications of GERD and their comparison between the groups were not noted in this study (a limitation). Although hydrogen impedance is used for diagnosis, the comparison of impedance parameters is not provided. H pylori infection is a protective factor for GERD/Barrett's, which is also a limitation. This study has provided a meaningful conclusion regarding the association between long-term symptoms and refractoriness.