Sara Kamionkowski, DO1, Ronnie Fass, MD, FACG2, Stephen Ganocy, PhD1, Fahmi Shibli, MD2; 1MetroHealth Medical Center, Cleveland, OH; 2MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
Introduction: Gastroesophageal reflux disease (GERD) has been shown to be associated with various psychiatric or neurocognitive disorders such as anxiety and depression. Those with autism spectrum disorder (ASD) are prone to gastrointestinal (GI) diseases, but most research has been done on children. Research in adults with ASD and GI disorders is greatly lacking. Our aim was to determine the effect of autism on GERD by comparing autistic adults wither GERD to patients with GERD but without autism. Methods: Data extrapolated from IBM Explorys Cohort Discovery program was used for this study. Each cohort of adults with GERD with and without ASD included adults aged 18 and above. Complications of GERD studied included Barrett’s esophagus, erosive esophagitis, esophageal strictures, extraesophageal manifestations such as chronic cough and asthma, esophageal ulcers, esophageal adenocarcinoma, and hiatal hernia). GERD treatment that was evaluated included proton pump inhibitors (PPIs), H2 blockers, both PPIs and H2 blockers, and anti-reflux surgery. Results: In this study, there was an association between ASD and GERD with an odds ratio of 2.02 (CI 1.97 to 2.07, p-value < 0.0001). The two complications of GERD shown to occur much more often in those with ASD were erosive esophagitis and esophageal ulcers. In the cohort with ASD, 8.84% developed erosive esophagitis versus 5.91% in those without ASD (p-value < 0.0001). In addition, 1.52% of those with ASD developed esophageal ulcer vs 0.72% without ASD (p-value < 0.0001). Interestingly, more patients with ASD were diagnosed with asthma for the first time within five years of having GERD (23.63% vs 5.55% without ASD, p-value < 0.0001). Patients without ASD were much more likely to have hiatal hernia 0.55% vs 0.15%, p-value < 0.0001). (Patient’s without ASD were also more likely to be on either only a PPI or both PPI and H2 blocker (p-value 0.003 and 0.02 respectively). Those with ASD were much more likely to be on only an H2 blocker (p-value < 0.0001). Discussion: This study shows that it is not uncommon for adults with ASD to suffer from GERD as do many adults without ASD. However, ASD patients are more likely to have GERD complications including erosive esophagitis or ulcers. Extraesophageal complication of asthma is much more likely to occur in those with ASD and GERD. Patients with ASD and GERD are likely to be treated less aggressively than those without ASD.
Disclosures: Sara Kamionkowski indicated no relevant financial relationships. Ronnie Fass indicated no relevant financial relationships. Stephen Ganocy indicated no relevant financial relationships. Fahmi Shibli indicated no relevant financial relationships.