P192 Heartburn in Crohn's disease is associated with increased disease activity, poor sleep quality and prior ileocecectomy
Bibliographic record
Abstract
Background: Patients with Crohn's disease (CD) commonly report symptoms of heartburn, however the prevalence, predisposing factors, and relationship between heartburn and CD are not known. We assessed the prevalence of heartburn in patients with CD and investigated the association between gastro-oesophageal reflux disease (GORD) and CD manifestations, treatment, and sleep quality. Methods: We recruited patients (pts) with CD from an ambulatory clinic at a tertiary care inflammatory bowel disease center. Pts completed a survey that included the validated GORD Health Related Quality of Life (GORD-HRQL) instrument and Pittsburgh Sleep Quality Index (PSQI). We abstracted clinical data from medical records including medical history, CD classification, medications, and Harvey-Bradshaw Index (HBI). Simple statistical analysis was performed for univariate associations, followed by multivariate logistic regression analysis. Results: 111 pts with CD were included in the analysis. The mean age was 42 years, mean body mass index (BMI) was 26.31, and the population was 60.4% female. The most common Montreal classification was A2 (59.5%), L3 (55.0%, 9.9% L4), and B1 (50.5%). 63.9% of pts with CD reported heartburn. Pts with and without heartburn were of similar age, sex, smoking status, location of disease, and disease behavior. Pts with heartburn had a higher mean BMI and less frequent alcohol use (Table 1). Female sex (OR 3.06 (95% CI 1.18–7.90), p=0.02), BMI (OR 1.12 (1.03–1.22), p=0.01), alcohol use (OR 0.47 (0.24–0.90), p=0.02), current steroid use (OR 3.70 (1.17–11.67), p=0.03), and history of ileocecectomy (IC) (OR 4.27 (1.41–12.89), p=0.01) were associated with heartburn (Table 2). Pts with heartburn reported less satisfaction with their current condition (p=0.005), worse sleep (PSQI mean 7.35 v. 4.63, p<0.001), and higher mean HBI (2.54 v. 1.20, p=0.017). Pts within 5 years of IC had a similar rate of heartburn as those whose surgery was more than five years prior, but of less severity (GORD-HRQL 4.30 v. 12.05, p=0.02). Table 1. Characteristics of patients reporting heartburn symptoms compared to patients that do not report heartburn symptoms Table 2. Multivariate analysis of factors to predict the presence of heartburn symptoms in Crohn's disease determined by logistic regression OR = Odds Ratio; CI = Confidence Interval. Conclusions: Heartburn in CD is associated with poor sleep quality and increased disease activity. In addition, we newly identified prior IC as a risk factor for heartburn in CD, which may reflect motility alterations due to surgery or fibrosis in these pts. Further investigation into heartburn in CD pts and its management is warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".