OBJECTIVES: Extraesophageal symptoms of GERD may result in GERD diagnosis in non‑gastrointestinal (GI) departments, the evidence for which, is limited. This subgroup analysis of the retrospective, real‑world GRAND China study describes the diagnosis, symptom subtypes, and treatment patterns among patients with GERD detected in non-GI departments.

METHODS: Pooled patient data of a GERD diagnosis were extracted from electronic medical records (January 2015–December 2017) of 11 hospitals (10 provinces). Symptoms assessed were typical (heartburn, regurgitation), atypical (chest pain, dysphagia, epigastric pain, belching, bloating, nausea, vomiting), or extraesophageal (globus sensation, cough, asthma, laryngitis, dental erosion). Non‑GI departments included departments of otolaryngology (ENT), respiratory, cardiovascular (CV) and others, such as, general medicine, general surgery, and traditional Chinese medicine. Descriptive analyses were performed.

RESULTS: Of 71,904 patients diagnosed with GERD, 34.4% were diagnosed in non-GI departments (14.0%, ENT; 0.9%, respiratory; 0.2%, CV; 19.3%, others). Between 2015 and 2017, a steady increase in diagnosis was observed in the ENT department (10.5%, 2015; 13.8%, 2016; 17.6%, 2017); respiratory (1.0%, 0.9%, 0.7%), CV (0.1%, 0.2%, 0.2%), and other (22.9%, 19.0%, 16.3%) departments showed decreasing or similar trends. Patients reported atypical (overall, 40.9%; respiratory, 26.5%; ENT, 13.2%; CV, 84.6%; others, 44.5%), typical (35.3%, 12.3%; 17.0%; 23.1%; 40.8%), and extraesophageal (35.6%; 68.8%; 71.7%; 27.6%) symptoms. Therapies were prescribed as combination (66.1%) or monotherapy (33.9%). Proton pump inhibitors (PPIs) were most prescribed (94.0%), followed by prokinetic agents (57.5%), anti‑acid agents/mucosal protectants (24.4%), and H₂ antagonists (2.4%). Most prescriptions were higher-than‑standard doses (47.9%); up to 31.6% were for twice-daily dosing frequency.

CONCLUSIONS: GERD patients are diagnosed in non-GI departments based on the presentation of atypical and extraesophageal symptoms; there is an increasing trend for diagnosis in ENT departments. Results indicate unmet needs in treatment of GERD in non-GI departments based on prescription of combination therapy, higher-than-standard dose, and twice-daily frequency.