Gastro-esophageal Reflux Is Common in Prader-Willi Patients, Study Shows

The prevalence of gastro-esophageal reflux disease (GORD), a condition also known as GERD, was found to be high among patients with Prader-Willi syndrome (PWS), a new study shows.

Researchers also found a strong link between tooth wear, or loss of tooth substance, and the prevalence of GORD, as well as with the consumption of acidic foods and drinks.

Their findings were reported in the study, “Gastro-oesophageal reflux – an important causative factor of severe tooth wear in Prader-Willi syndrome?” published in the journal Orphanet Journal of Rare Diseases.

Prader-Willi is commonly associated with oral abnormalities, such as a decrease in salivary flow, formation of thick saliva, and extreme tooth wear.

Tooth wear may result from attrition between opposing teeth, abrasion with foreign objects, or erosion due to acidic substances produced or entering the digestive system. In some cases, tooth wear is from a combination of these factors.

Studies have shown an increase in reflux symptoms in individuals with sleep apnea and obesity, some of the characteristics associated with PWS, but they have not been directly linked to the disease.

Now, researchers investigated the prevalence of gastro-esophageal reflux in children and adults with PWS, as well as a possible link between GORD and tooth wear in adult patients.

The study was developed at the TAKO Center, a Norwegian resource center for oral health in rare medical conditions, located in Oslo. Twenty-nine patients were enrolled in the study, 17 adults with a mean age of 32.6 and 12 children with a mean age of 8.8.

All patients underwent esophageal monitoring of pH levels, a measurement of acidity.

Both children and adults were categorized according to their body mass index (BMI), but only adults were analyzed for tooth wear, since many children still had mixed dentition.

Gastro-esophageal reflux disease was diagnosed in four children and 11 adults exposed to acidic substances (pH less than four), meaning a GORD prevalence of 52% in Prader-Willi patients.

Adult patients diagnosed with gastro-esophageal reflux were divided into two groups: one presenting reflux symptoms more than 4.3% of the time (the reflux group), and another group with reflux symptoms less than 4.3% of the time (the non-reflux group).

Twice as many individuals in the reflux group, compared to the non-reflux group, consumed high-acidic foods and drinks.

Results also suggested a significant correlation between increased tooth wear and GORD in both reflux and non-reflux groups.

Overall, the team concluded that “the prevalence of gastro-oesophageal reflux is high in individuals with PWS. Tooth wear was strongly associated with GORD and acidic drinks, and both may be important etiological factors underlying the extreme tooth wear in this group.

“Our data suggest a need for routine screening for GORD and dental wear in young individuals with Prader-Willi syndrome,” the researchers suggested.