Prevalence, diagnosis and treatment of gastro-oesophageal reflux disease in institutionalised persons with an intellectual disability

The prevalence of gastro-oesophageal reflux disease (GERD) has been suggested to be high in persons with an intellectual disability (ID). However, this has never been randomly investigated. Also, the therapeutic approach to GERD in IDI has not been studied extensively. Therefore, we studied the prevalence of GERD among IDI and the effects of omeprazole on healing and symptom relief. Four hundred and thirty-five persons with an IQ < 50 underwent 24 hour oesophageal pH testing, and after endoscopy the effects of omeprazole were evaluated. Almost 50% showed a pathological pH test. In almost 90% the treatment scheme was effective in healing the oesophagitis and keeping the patients in remission, independent of the severity of the oesophagitis. A marked improvement in symptoms was seen. GERD is a major clinical problem in IDI, and is frequently overlooked and underrated. The prevalence of GERD is high. In this difficult group of patients it appeared to be relatively easy to diagnose GERD by pH testing and/or endoscopy. Also, it was demonstrated that in IDI, omeprazol is highly effective with only a few minor side-effects.