Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study

BMC Gastroenterology, 06/14/2012

The first large cohort study of the association between gastro–oesophageal reflux disease (GORD) and hormone replacement therapy (HRT) found a statistically significant association between oestrogen–only hormone and GORD and proton–pump inhibitor (PPI) use. This should be further investigated using prospective follow–up to validate the strength of association and describe its clinical significance.

Methods

  • 51,182 menopausal women were identified using the UK General Practice Research Database between 1995-2004.
  • Of these, 8,831 were matched with and without hormone use.
  • Odds ratios (ORs) were calculated for GORD and proton-pump inhibitor (PPI) use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy.

Results

  • In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen) were statistically significantly associated with GORD.
  • In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18-1.89).
  • Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment.
  • When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03-1.74).
  • Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01- 2.22).

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