ORIGINAL RESEARCH
Kimberly Schiel, MD; Timothy Chrusciel, MPH; Richard Gruzca, PhD; Jeffrey F. Scherrer, PhD
Corresponding Author: Kimberly Schiel, MD; Department of Family and Community Medicine, Saint Louis University School of Medicine
Email: Kimberly.schiel@ssmhealth.com
DOI: 10.3122/jabfm.2024.240426R1
Keywords: Alcohol Drinking, Alcohol Use Disorder, Gastritis, Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, Mental Health, Primary Health Care
Dates: Submitted: 11-27-2024; Revised: 02-18-2025; Accepted: 03-03-2025
Status: In production for ahead of print.
BACKGROUND: Despite the availability of safe and effective outpatient treatments for alcohol use disorder (AUD), primary care physicians screen and treat only a fraction of their patients with AUD. To better detect AUD, it may be effective to evaluate whether the known gastrointestinal consequences of heavy alcohol consumption are linked to subsequent AUD diagnoses. This study examined whether irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD) and gastritis/ulcer were associated with a new AUD diagnosis.
METHODS: De-identified medical record data from a large Mid-western health care system was used to identify primary care patients without an AUD diagnosis in 2020 and 2021. Separate multivariate regression models were computed to estimate the association between each GI condition measured in 2020 and 2021 and odds of AUD diagnoses in follow-up (2022-2023).
RESULTS: The average age was 56.0 (SD 17.1) years old. Patients were most commonly White race (87.6%). GERD (24.8%) was much more prevalent than either IBS (3.4%) or gastritis/ulcer (2.5%). After adjusting for covariates, there was no significant association between gastritis/ulcer or IBS and a new diagnosis of AUD within two years. However, after adjusting for all covariates GERD was significantly associated with new AUD diagnoses (OR=1.18; 95%CI:1.10-1.26).
CONCLUSIONS: This study suggests that primary care physicians should screen their GERD patients for AUD, as these patients are at higher risk of being diagnosed with AUD within two years. Further research is needed to determine patient acceptability to discussing AUD following a GERD diagnosis as compared to standard screening.