Reduced masticatory function predicts gastroesophageal reflux disease and esophageal dysphagia in patients referred for upper endoscopy: A cross-sectional study

Background: The role of mastication on gastroesophageal reflux disease (GERD) is unknown. Aims: To assess whether reduced masticatory function predicts GERD and esophageal dysphagia in pa-tients investigated with upper endoscopy.Methods: In this cross-sectional study, 179 adult patients referred for elective upper gastrointestinal en-doscopy agreed to participate. Before endoscopy, an expert dentist performed an oral examination and scored chewing function in three levels (normal, regular, and reduced). Patients replied questionnaires for assessment of GERD (heartburn, regurgitation, and dysphagia), xerostomia, and mastication (normal, regular, and reduced). Poor chewing was defined when either oral examination or mastication question-naire rated the chewing function as reduced. Associations of mastication with GERD and dysphagia were estimated using Poisson regression. Results: Eleven patients were excluded. Among 168 analyzed (aging 49.8 +/- 15.5 years; 58.9% women), 46 had reduced masticatory function (27.4%), and 122 had regular/normal mastication (72.6%). Reduced mas-tication was associated with GERD [PR = 1.38 (95%CI 1.12 - 1.70)], adjusting for age, and with esophageal dysphagia [PR = 2.03 (95%CI 1.02 - 4.04)], adjusting for age and xerostomia. Conclusions: In outpatients referred for upper gastrointestinal endoscopy, reduced masticatory function defined by an expert dentist may be a risk factor for GERD and esophageal dysphagia.(c) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.