Clinical characteristics and risk factors of esophageal reflux hypersensitivity: A multicenter study

BACKGROUND Reflux hypersensitivity (RH) constitutes roughly 14% of patients with heartburn and 34% of those with refractory heartburn, yet it is inadequately comprehended. AIM To investigate the clinical characteristics and risk factors associated with RH. METHODS We conducted a retrospective analysis of 109 patients with RH and 384 healthy controls from three medical centers between January 2022 and December 2023. Comprehensive data encompassing symptoms, motility, impedance-pH monitoring, and psychological evaluations were collected. RESULTS RH patients encountered a greater frequency of weakly acidic reflux (WAR) events compared to acidic reflux or nonacidic reflux (NAR) events. Upright reflux time (1.22%) exceeds supine reflux time (0.54%) (P < 0.05). Extraesophageal symptoms were more prevalent among younger patients and those with elevated NAR (P < 0.05). The acidic reflux, WAR, NAR, and peristaltic contraction break length in male patients exceeded those in female patients (P < 0.05). Age [odds ratio (OR) = 5.633], hiatal hernia (OR = 13.103), and anxiety (OR = 17.342) constituted independent risk factors for RH. CONCLUSION WAR and NAR are pivotal in RH. Patients with increased NAR are more likely to experience extraesophageal symptoms. Age, hiatal hernia, and anxiety are significant independent risk factors for RH.