Prevalence of symptoms of gastroesopahgeal reflux in a cohort of Saudi Arabians: a study of 1265 subjects

Associations of Plant-Based Foods, Animal Products, and Selected Sociodemographic Factors with Gastroesophageal Reflux Disease Risk

BACKGROUND

Diet influences the symptoms of gastroesophageal reflux disease (GERD). Plant-based diets rich in vegetables, fruits, legumes, seeds, and nuts may reduce inflammation and improve gut health, while high-fat foods may worsen symptoms.

OBJECTIVE

We examined the association between plant-based and animal-based foods, selected demographic characteristics, and the likelihood of GERD in Al Madinah Al Munawarah, Saudi Arabia.

METHOD

A cross-sectional study using the GerdQ tool assessed the GERD likelihood among 303 adults. Dietary diversity scores were used to assess the quality of their diet. quality.

RESULTS

The participants were predominantly women (68.6%) and had low education levels (88.4%). Cereals were the most consumed plant-based foods, while vitamin A-rich fruits and vegetables were the least consumed. There was significant variation in the consumption of legumes, nuts, seeds, and milk and milk products among the GERD groups. The participants with a 50% GERD likelihood had the highest consumption (34.5%), followed by the 89% likelihood group (21.4%) and the 79% likelihood group (14.5%). The lowest consumption of milk and milk products was among those with an 89% GERD likelihood who also consumed more organ meat. In addition, GERD likelihood was inversely associated with age (r = -0.153; p = 0.008). The likelihood of GERD was negatively correlated with the intake of legumes, nuts, and seeds (r = -0.163; p = 0.005). Furthermore, the intake of cereals and tubers (r = 0.114; p = 0.047) and legumes, nuts, and seeds (r = 0.231; p = 0.0001) increased significantly with education.

CONCLUSION

GERD prevention programs should target women, those with a low education level, and individuals consuming fewer plant-based foods and more organ meats.

Prevalence and risk factors of gastroesophageal reflux disease among adults attending primary healthcare in Bahrain

Background

Gastroesophageal reflux disease (GERD) is one of the most diagnosed digestive disorders, with much-conducted research assessing its prevalence and risk factors associated with it worldwide. However, there are no published previous studies to determine such disease and its burden in Bahrain. Hence, this study aims to estimate the prevalence and evaluate the risk factors associated with GERD among adults attending primary care in Bahrain.

Material and Methodology

A total of 385 adults aged 18 years and above participated in this descriptive cross-sectional study in the period from 1st to 27th of April 2023. The sample was collected randomly through an interview-based validated questionnaire from 10 health centers selected randomly. The questionnaire consisted of three sections: Demographic characteristics, risk factors that are associated with GERD and (GERD-Q) questionnaire with a scoring rate for the diagnosis of GERD, in which a score of 8 or more gives us the diagnosis of GERD.

Results

A response rate of 93.6% was accomplished. Most of the participants were female (53.2%), Bahraini (88.6%), university-educated (50.9%) and married (71.2%). The mean age of the participants was 41.5 (SD = ±14.4 years). The prevalence of GERD was 41.5% which was statistically significant associated with family history of GERD, history of hypertension, sleeping within less than 1 hour after dinner, bariatric surgery and use of NSAIDs or Aspirin regularly (P < 0.05).

Conclusions

The prevalence of GERD was 41.5%, which is higher than in the Middle East, East Asia and Western countries. Many modifiable risk factors where associate with it which deserves the conduction of national prevention programs and educational campaigns to prevent this disease and its complications. Further studies are needed to assess other risk factors and the effect of GERD on the overall health status and quality of life.

Psychological factors, lifestyle habits, and their association with gastroesophageal reflux disease among Egyptian university students: A cross-sectional study

Gastroesophageal reflux disease (GERD) is a common condition among university students that is associated with various lifestyle and psychological factors. The study aims to evaluate the association of psychological factors, physical activity, and dietary habits with the prevalence of GERD among university students in Egypt. An analytical cross-sectional study was conducted from March 2024 to May 2024, selecting students from different universities in Egypt. A self-administered questionnaire covered sociodemographic characteristics, and GERD assessment using the Gerd Q questionnaire. Generalized Anxiety Disorder-2, Perceived Stress Scale 4, Nordic Physical Activity Questionnaire, and short dietary habits questions were used to assess anxiety, perceived stress, physical activity, and dietary habits, respectively. Statistical analysis included descriptive statistics, correlation analysis, and hierarchical logistic regression, which were employed to identify significant predictors of GERD. Among the 2241 university students, 22.6% had GERD (GerdQ score > 8), 86.3% had high perceived stress, and 62.2% had high anxiety levels. Hierarchical logistic regression analysis identified old age, high weight, short height, frequent consumption of fried/fast food, and high anxiety levels as significant predictors of GERD. The study underscores the importance of considering psychological factors and dietary habits alongside traditional risk factors in understanding and addressing GERD among university students in Egypt. Public health interventions targeting psychological well-being and healthier dietary habits will play a pivotal role in reducing this population's GERD burden.

The prevalence, severity, and risk factors of erosive esophagitis in a Middle Eastern population

BACKGROUND

Erosive esophagitis (EE) is frequently present in patients with gastroesophageal reflux disease (GERD), some of which may not have GERD symptoms. The prevalence of EE in the Saudi population is unknown. In this study, we aimed to determine the prevalence and risk factors of EE among patients undergoing esophagogastroduodenoscopy (EGD).

METHODS

We retrospectively reviewed consecutive adults who underwent EGD at an academic tertiary care center. Clinical and endoscopic data were collected. The prevalence and severity of EE were determined. Multivariate regression analysis was used to identify risk factors for EE.

RESULTS

Records for 3230 patients were reviewed, of which 2805 were included in this study. The mean age was 48.6 ±18.6 years, and 1088 (38.7%) were male. Two hundred and twenty six (8%) patients underwent EGD for GERD-related indications. EE was noted in 309 (11%) patients and 58 (25.6%) with GERD-related indications. For patients with EE, the mean age was 49.2 ± 18.7 years, and 132 (42.7%) were males. LA Grade A esophagitis was the most common (53.9%), followed by grade B (29.6%). Among all patients, only EGD for GERD-related indications and hiatal hernia were significantly associated with EE on multivariate analysis [(aOR = 3.1, 95% CI 2.2-4.4, P < 0.01) and (aOR = 1.4, 95% CI 1.1-1.9, P < 0.01), respectively]. Age, gender, and body mass index were not associated with EE.

CONCLUSION

In this large cohort, EE was present in 11% of patients who underwent EGD and in 25% of patients with GERD. EGD for GERD-related indications and hiatal hernia are independent risk factors for the presence of EE.

The Saudi Gastroenterology Association consensus on the clinical care pathway for the diagnosis and treatment of GERD

ABSTRACT

Gastroesophageal reflux disease (GERD) is one of the most common problems encountered in outpatient general medicine and gastroenterology clinics. GERD may present with classic esophageal symptoms, extraesophageal symptoms, or mixed symptoms. The diagnosis and treatment of GERD are challenging due to the variety of symptoms and multifactorial pathophysiology. Since there is no consensus on the diagnosis and treatment of GERD in Saudi Arabia, the Saudi Gastroenterology Association established an expert group to formulate a consensus on the clinical care pathway for the diagnosis and treatment of GERD to update health-care providers in Saudi Arabia. The expert group reviewed the literature including recently published international guidelines, clinical trials, and expert opinion and conducted virtual and in-person meetings. A total of 22 statements on the definition, diagnosis, and treatment of GERD were formulated, and three algorithms for the clinical care of GERD were developed with a detailed description for each step. The expert group endorsed the new definition of GERD, the practical principles of interpretation of the diagnostic GERD evaluation, and the practical guidance for GERD treatment including medical, surgical, and endoscopic therapy. The expert group recommends further studies to investigate local data on the diagnosis and treatment of GERD.

The Prevalence of Gastroesophageal Reflux Disease (GERD) in H. pylori-Positive and -Negative Patients

INTRODUCTION

The presence of Helicobacter pylori (H. pylori) infection can influence gastric acid production. While both gastroesophageal reflux disease (GERD) and H. pylori are highly prevalent in the Saudi Arabian population, the relationship between these two conditions remains uncertain. This study aims to assess the association between GERD and H. pylori.

METHODS

This was a cross-sectional study which included patients who underwent endoscopy with gastric biopsy to test for H. pylori. H. pylori status was assessed using histopathology. The GERD-Q questionnaire was used to ascertain the presence of GERD. Multivariate analysis was used to assess the relationship between H. pylori and GERD.

RESULTS

A total of 352 participants were included, with a mean age of 45 years (±14.7) and 58% of them being female. 148 participants (42%) tested positive for H. pylori. 59 (39.9%) had GERD. GERD was identified in 39.9% of the H. pylori-positive group and 37.3% of the H. pylori-negative group. H. pylori was not significantly associated with GERD in the multivariate analysis (P = 0.726, OR = 1.089, 95% CI: 0.675 - 1.759).

CONCLUSION

There was no association between H. pylori infection and GERD in this Saudi Arabian population.

Exploring the Prevalence of Functional Gastrointestinal Diseases and the Accompanied Differences in Dietary and Lifestyle Patterns: A Two-Generational Study

BACKGROUND AND OBJECTIVES

Generation Z and millennials in Saudi Arabia both experienced the stress of the COVID-19 pandemic and the accompanying factors that may have had an impact on the incidence of functional gastrointestinal diseases (FGIDs) in both generations. This study aims to explore how prevalent FGIDs are among adolescents and their parents.

METHODS AND STUDY DESIGN

A cross-sectional, school-based study conducted in public high schools for boys and girls in Jeddah, Saudi Arabia. We adapted 37 items from the ROME IV Diagnostic Questionnaires for children and adults, as well as other questionnaires. IBM SPSS Statistics (Version 28.0) was used.

RESULTS

Generation Z showed a higher prevalence of FGIDs (33.5%, n = 126) in comparison with millennials (20.0%, n = 28). In both generations, the most prevalent FGID was functional constipation; the least prevalent were irritable bowel syndrome and abdominal migraine, with no significant change in the severity or frequency of symptoms during the pandemic. The type of commonly consumed beverages was a risk factor for FGIDs. Participants in generation Z were less likely to use complementary and alternative medicine (67.4%) to prevent diseases and enhance immunity compared with millennials (82.9%).

CONCLUSIONS

The study results confirmed disparities in the prevalence of FGIDs between the two generations before and during the COVID-19 pandemic, which requires further research in other areas of Saudi Arabia. Recognizing the differences between the millennial parents and the generation Z high schoolers could assist health professionals in planning individualized, generation-based interventions and educators in designing and tailoring programs based on generational differences.

Prevalence of Gastroesophageal Reflux Disease and Its Impact on the Quality of Life Among Obese Individuals in Al-Baha Region, Saudi Arabia

Background Gastroesophageal reflux disease (GERD) is a global gastrointestinal disorder, and obesity is a particular risk factor. Symptoms of GERD, such as heartburn and acid reflux, are caused by abnormal relaxation in the lower esophagus, causing gastric acid reflux. Persistent symptoms can affect the patient's quality of life (QOL) and can cause complications, such as esophageal adenocarcinoma. Management of GERD includes lifestyle changes, antacids, and anti-reflux surgery. Even though GERD is a common disease, few research has been carried out on it in Saudi Arabia. Aim This study aimed to estimate the prevalence of GERD and its associated risk factors among obese individuals in the Al-Baha region population and the effect of GERD on their QOL. Methods A cross-sectional study included 314 obese participants from the Al-Baha region. A questionnaire was filled out to measure the prevalence of GERD, risk factors, and effects on the QOL of the participants. Data were analyzed by the IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). Descriptive statistics and the chi-squared test were applied. Logistic regression analysis was used to determine the factors associated with the incidence of GERD. A p-value of <0.05 was considered statistically significant. Results A total of 314 patients who met our inclusion criteria completed the survey; 42% of them were women, the mean age of all patients was 35.3 ± 12.9 years, and 38.2% of the patients were diagnosed with GERD. Epigastric pain and burning sensation were the most common symptoms (44.9%). Five out of six domains in the QOL questionnaire showed more effects among GERD participants than non-GERD participants, and the results were statistically significant (p = 0.001). Logistic regression analysis showed that men are 1.8 times more likely than women to be diagnosed with GERD, and smokers have 2.6 times the risk of being diagnosed with GERD than non-smokers. Conclusion The present study showed a high prevalence of GERD among obese patients in the Al-Baha region, negatively affecting their QOL. Major risk factors included gender, smoking, dyslipidemia, and hypertension. Public health programs to raise awareness of these risk factors and lifestyle habits are necessary to improve QOL and prevent complications.

Impact of Gastroesophageal Reflux Disease (GERD) Symptoms on the Lifestyle and Academic Performance of Medical Students at King Faisal University

Background A number of symptoms and complications are associated with gastroesophageal reflux disease (GERD), which originates when stomach contents are refluxed into the esophagus. GERD has been associated with quality of life (QoL) issues as well as health-related problems. However, the evidence of this correlation among medical students is still unproven. This study aims to assess GERD severity and symptoms among medical students and investigate the effects of GERD on academic performance and quality of life among Saudi Arabian medical students. Methods This is a cross-sectional study design based on questionnaires distributed among medical students at King Faisal University, Saudi Arabia: Reflux-Qual Short form (RQS) and Frequency Scale for the Symptoms of GERD (FSSG). Demographic data include gender, academic year, and Grade Point Average (GPA). The participants included 382 studentsrandomly selected as the sample size, with a precision of 5% and a 95% confidence interval (CI). Results Data were collected from 382 medical students of King Faisal University. A total of 382 participants (215 (56.3%) females and 167 (43.7%) males) were evaluated. Among 382 students,325 (85.1%) were negative for GERD, while 57 (14.9%) had symptoms of GERD. In this study, the most frequent symptoms were feeling full while eating meals (8.9%), feeling of heaviness after meals (6.5%), bloating of the stomach (3.7%), and burping (3.7%). The most affected life domains were life satisfaction (18.1%), enjoyment of food (8.4%), avoidance of large meals (6.3%), and worrying about digestive problems (5.8%). This study shows a significant relationship between GERD and GPA (P < 0.005) and a significant negative relationship between GERD and QoL (P < 0.001). Conclusions GERD significantly affects the quality of life for medical students, primarily those with high GPAs. More research is needed to determine the reason behind this.

Generalized Anxiety Disorder Associated With Gastroesophageal Reflux Disease Among the Saudi Population

Objectives In Saudi Arabia, the prevalence of generalized anxiety disorder (GAD) was reported to be 29%. As a result, our goal was to examine the association between GAD and gastroesophageal reflux disease (GERD) within the general Saudi Arabian population, as well as to access the risk factors for GAD in order to gain a better understanding. Method This cross-sectional study involved 4,224 participants who completed a questionnaire. Anxiety was assessed using the General Anxiety Disorder-7 (GAD-7) scale, and the GerdQ tool was used to evaluate GERD. Result The prevalence of anxiety among participants was 29% at cutoff 10, with 73% of anxiety-positive participants being female and only 26.9% being male. Furthermore, the associations between anxiety and GERD were significant as 31.4% of participants with anxiety had GERD, compared to 15.0% of those without anxiety. Conclusion In our finding, there was a significant association between anxiety and GERD among the general Saudi population. In terms of anxiety risk factors, female, younger age, social status, body mass index, eating fried food, caffeinated drinks, diabetes miletus, high blood cholesterol, NSAID use, antidepressants, and anti-anxiety medication were found to have a significant association.

The Prevalence of Gastroesophageal Reflux Disease in Azerbaijan: A Population-Based Cross-sectional Study

BACKGROUND/AIMS

The prevalence of gastroesophageal reflux disease in Azerbaijan has not been evaluated before. The aim of our study was to determine the prevalence of gastroesophageal reflux disease based on the validated reflux questionnaire.

MATERIALS AND METHODS

A total of 1026 individuals from 7 regions of Azerbaijan were included in the cross-sectional study conducted via face-to-face administration of the validated Mayo Clinic's gastroesophageal reflux disease questionnaire. Gastroesophageal reflux disease was diagnosed if an individual had heartburn and/or regurgitation occurring at least once a week.

RESULTS

The prevalence of gastroesophageal reflux disease in Azerbaijan was 22.7% with significant female predominance (26.1% vs. 15.3%; P < .0001). Gastroesophageal reflux disease was prevalent in 17% of those aged below 35 years; 22.7% of those in the age range 36-55 years, and 38.5% of those who are above 56 years, which, accordingly, indicates that gastroesophageal reflux disease becomes significant as age increased (P < .0001). Male respondents younger than 35 years had much lower rates of gastroesophageal reflux disease than in older groups (5.7% vs. 22.7%, P < .0001), whereas in females older than 55 years, age was a significant factor for increasing gastroesophageal reflux disease symptoms (22.6% vs. 50%, P < .001). Reflux was observed in 18.1% of normal-weight respondents (body mass index 18.6-24.9), 25.6% of overweight (body mass index 25-29.9), and 30.4% of obese ( body mass index > 30) individuals (P = .001). Regarding marital status, the prevalence was the lowest in the single subjects' group (17%), close to average in the married group (23.8%), and the highest (41.7%) in divorced/widowed cases (P = .003). Stress significantly affected the gastroesophageal reflux disease distribution, affecting 59.4% of all respondents (P < .004).

CONCLUSION

Gender, body mass index, increased age, marital status, and stress were precipitating factors of gastroesophageal reflux disease. Socioeconomic diversity, along with lifestyle/habits, did not play a crucial role in the gastroesophageal reflux disease prevalence distribution.

Prevalence and Risk Factors for Gastroesophageal Reflux Disease (GERD) Among Visitors to the Health Center of Imam Mohammad Ibn Saud Islamic University

BACKGROUND

A considerable majority of people have gastroesophageal reflux disease (GERD), a common gastrointestinal ailment. Globally, the prevalence of GERD has been rising, and it is linked to several risk factors. In this study, the incidence of GERD in a sample of the population was examined, along with the associated factors that may have an impact on it.

METHODOLOGY

 The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) was included in a self-administered survey given to 490 participants in a cross-sectional study to help determine who was more likely to have GERD. The questionnaire collected data on demographic elements, health-related traits, and past GERD diagnoses.

RESULTS

The findings revealed that 32.7% of the individuals had previously received a GERD diagnosis. Of the patients, 17.1% had a GERD-Q score of 8 or above, which indicates a higher likelihood of having GERD. Participants who had previously been diagnosed with GERD had a noticeably greater incidence of GERD, and females had a higher incidence of GERD than males. The frequency of caffeine consumption was substantially correlated with the occurrence of GERD.

CONCLUSION

Our study emphasizes the value of early GERD diagnosis and therapy to reduce problems and enhance the quality of life for those who are affected. According to our research, coffee use, gender, and prior GERD diagnoses are all linked to an increased risk of developing GERD. The GERD-Q is a trustworthy and proven tool for GERD diagnosis and might be used in clinical practice to recognize GERD patients and offer suitable treatment. Additional research is required to determine how additional risk variables affect the prevalence of GERD.

The prevalence and risk factors for hiatal hernia among patients undergoing endoscopy: A retrospective analysis

OBJECTIVES

To determine the prevalence of hiatal hernia (HH) and its association with age, gender, and body mass index (BMI).

METHODS

We retrospectively included patients who underwent esophagogastroduodenoscopy (EGD) at an academic tertiary care hospital. Data were collected on the presence of HH as well as patient demographics including age, gender, and BMI. Univariate and multivariate analysis were done to determine risk factors for HH.

RESULTS

A total of 2805 patients were included in this study. The mean age was 48.6 (±18.6) years and males constituted 28.8% of the study population. The mean BMI was 29.7 (±8.6) kg/m². The prevalence of HH was 29.8% among all patients and 48.6% among those who underwent EGD for gastroesophageal reflux disease-related indications. There was no significant association between HH and female gender (OR 1.04, 95%CI: 0.88 -1.26, p=0.53), older age (OR 0.77, 95%CI: 0.72 - 1.06, p=0.19) or BMI (OR 1.07, 95%CI: 0.9 - 1.2, p=0.39).

CONCLUSION

The prevalence of HH was 28.9% based on this large endoscopy-based population. We found no association between HH and gender, age, or BMI.

The views of African and Middle Eastern Gastroenterologists on the management of mild-to-moderate, non-erosive gastro-esophageal reflux disease (GERD)

INTRODUCTION

Gastro-esophageal reflux disease (GERD) is a common gastrointestinal disorder that occurs when backflow of the gastric contents into the esophagus results in troublesome symptoms. Though GERD has been extensively studied in Western populations, literature on the management of GERD in patients in Africa and Middle East (AME) is scarce.

AREAS COVERED

In this review, we provide an overview of the management of mild-to-moderate GERD in AME. Here we focus on the efficacy and safety of currently available treatments for GERD to help physicians and community pharmacists appropriately manage patients with mild-to-moderate GERD in the primary healthcare setting, detailing specific situations and patient scenarios that are relevant to the region, including management of GERD during Ramadan and post-bariatric surgery.

EXPERT OPINION

Under-appreciation of the burden of GERD in the region has resulted in a lack of consensus on management. Barriers that currently prevent the adoption of treatment guidelines in the primary healthcare setting may include lack of availability of local guidelines and referral systems, a paucity of region-specific research, and dogmatic adherence to traditional practice. By increasing awareness, strengthening knowledge, and by more effective utilization of resources, physicians and pharmacists could optimize GERD management strategies to better support patients.

Prevalence of Gastroesophageal Reflux Disease and Associated Risk Factors in the Eastern Region, Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is a common upper gastrointestinal disorder characterized by heartburn and acid regurgitation. A higher incidence is found in Arab countries. Untreated GERD has a negative impact on individuals that interfere with daily activities and impaired quality of life. This study aims to estimate the prevalence of GERD and associated risk factors in the Eastern region, Saudi Arabia.

Material & Methodology

A descriptive cross-sectional study was carried out among 1517 healthy participants from the Eastern province of Saudi Arabia from May to August 2021. The sample was randomly collected through a structured self-administered questionnaire. The questionnaire was composed of questions related to sociodemographic and lifestyle characteristics as risk factors for GERD. The existence of GERD was assessed by using GERD Questionnaire (GerdQ) for diagnosing GERD, when the score is 8 or more.

Results

A total of 1517 participants were included in the study: 58.8% male, 41.2% female; 9% of whom were pregnant. The age of participants ranged from 18 to 58 with a mean age of 27.5 ± 11.4 years old. The existence of GERD was 20.6% among the total participants, in which their GerdQ scores were 3-7 (68.9%), 8-10 (22.1%), and 8-11 (8.5%). The higher risk groups of having GERD were pregnant women, smoker, being male, regular usage of analgesia, soft drinks, and having a family history of GERD.

Conclusion

This study showed the prevalence of GERD among the general population of the Eastern region, Saudi Arabia was 20.6%. Several sociodemographic and lifestyle characteristics were associated with the disease. Further studies are needed to explore the role of psychological factors in developing GERD.

Prevalence of Gastroesophageal Disease and Associated Risk Factors Among the Population in Al-Qunfudah

Background and objective

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases worldwide. It causes an unpleasant effect on patients' lives and may lead to serious complications resulting in a significant burden on healthcare systems. Despite being a common gastrointestinal disease, very few studies have been conducted on the condition in Saudi Arabia; and there has never been a study to estimate the prevalence of GERD in the Al-Qunfudah Governorate. In light of this, we conducted this study with an aim to assess the prevalence of GERD and its associated risk factors among the Al-Qunfudah population.

Methods

A cross-sectional study was conducted in the Al-Qunfudah Governorate by using an online self-administrated questionnaire that was shared through social media during the first week of January 2021. The questionnaire consisted of a general section on sociodemographic data and a section on the diagnosis of GERD based on the validated gastroesophageal reflux disease questionnaire (GERD-Q). A total of 1,180 eligible participants responded to the questionnaire.

Results

Nearly one-third (32.9%) of the study participants had GERD based on their reported symptoms and calculated scores (GERD-Q score ≥8). About 14.8% of the participants (175/1,180) reported that they had already been diagnosed with GERD before their participation in our survey. Regarding risk factors of GERD, about 35% reported experiencing psychological stress, 28.3% had a family member diagnosed with GERD, and 18.1% were smokers; 49.4% of the participants had their symptoms aggravated by consuming fatty or fried food and 46.7% by spicy food. One of the factors that helped to relieve GERD symptoms was avoiding symptom-aggravating food, as reported by more than half (50.7%) of the participants.

Conclusion

The prevalence of GERD in the Al-Qunfudah population is high as the condition has affected one-third of the adult population. Our study confirms that male gender, age of 30 years or above, being overweight or obese, being married, smoking habit, use of non-steroidal anti-inflammatory drugs (NSAIDs), having psychological stress, being asthmatic, or having a family history of GERD are factors that significantly increase the likelihood of developing GERD. The reported risk factors include experiencing psychological stress, a family history of GERD, high BMI, and smoking.

Assessing the Degree of Gastroesophageal Reflux Disease (GERD) Knowledge Among the Riyadh Population

Background Gastroesophageal reflux disease (GERD) is a chronic disease mainly characterized by heartburn and acid regurgitation. To our knowledge, there have been a limited number of studies in Saudi Arabia looking at the knowledge level among the general population regarding this disease and its associated factors. Therefore, this study aims to identify the knowledge level of the disease and its associated factors, assess the prevalence of GERD among the Riyadh general population, and assess the need for educational programs for GERD. Methodology A cross-sectional study was conducted among the general public in Riyadh, Saudi Arabia. The degree of GERD knowledge was assessed by translating and editing Jorgen Urnes' 24-item questionnaire into Arabic. In addition, six questions related to the symptoms and complications of GERD were added. Convenience sampling was done by using a Google form to distribute the questionnaire. The questionnaire assesses GERD knowledge by asking about the signs, symptoms, risk factors, predisposing factors, and management of GERD. Statistical analysis was performed using R v. 3.6.3 (https://cran.r-project.org/bin/windows/base/old/3.6.3/). Counts and percentages were used to summarize the distribution of categorical variables. Results The questionnaire was completed by 664 respondents (48.2% males and 51.8% females). The average age of the included respondents was 34.1 ± 12.8 years and Saudis represented 97% of the included respondents. The majority of the respondents had heard of GERD (83%). The average number of correct answers was 12.7 ± 6.1. In total, 40 respondents did not answer any questions correctly. Approximately one-third of respondents answered >50% of the questions correctly (n = 250, 37.6%). Approximately half of the respondents identified all risk factors for GERD. Other common risk factors identified included caffeine (23.6%), fast food (26.8%), and smoking (17.6%). Slightly more than a quarter of the respondents reported being diagnosed with GERD (28.8%). Knowledge was significantly higher among respondents who had received a diagnosis of GERD. A statistically significant positive association was observed between age and knowledge (r = 0.19, p < 0.001). Conclusion The study shows a relatively good knowledge level compared to previously reported figures in Saudi Arabia and worldwide. Educational programs for GERD should be increased in Saudi Arabia and more health conferences and teaching school students of the disease should be highlighted to increase the general knowledge of this disease in the Kingdom of Saudi Arabia (KSA).

The Effect of Body Mass Index on the Prevalence of Gastrointestinal Symptoms Among a Saudi Population

Background: While multiple studies have evaluated the effect of body mass index (BMI) on the prevalence of gastrointestinal (GI) symptoms, data from Saudi Arabia are scarce. This study aimed to evaluate the association between GI symptoms and BMI in a Saudi population.

Methods: A prospective cross-sectional study was conducted between September 2019 and April 2020. The data were collected using an electronic self-administered questionnaire. The study included adult participants and collected data on patients’ demographics and GI symptoms. Participants with underlying GI diseases were excluded. A multivariate regression analysis was used to report the adjusted prevalence of GI symptoms in different BMI categories.

Results: A total of 4415 participants completed the survey. After applying the exclusion criteria, 3866 were included. The mean age was 26.3 (±8.8) and 58.2% were females. The mean BMI was 25.2 (±6.7), and the distribution of BMI was as follows: underweight 428 (11.1%), normal BMI 1789 (46.2%), overweight 912 (23.5%), and obese 737 (19.1%). After adjustment for age, gender, and smoking and coffee habits, obesity (BMI > 30) was significantly associated with heartburn (p < 0.01, aOR 1.6, 95% CI: 1.33 - 1.92), bloating (p < 0.01, aOR 1.31, 95% CI: 1.08 - 1.6), and diarrhea (p < 0.01, aOR 1.72, 95% CI: 1.36 - 2.17)). Underweight (BMI < 18.5) was significantly associated with abdominal pain (p < 0.01, aOR 1.4, 95% CI: 1.12 - 1.73), nausea (p < 0.01, aOR 1.6, 95% CI: 1.29 - 2.1), and vomiting (p < 0.01, aOR 2.02, 95% CI: 1.23 - 3.25). There was no significant association between BMI and constipation.

Conclusion: Obesity was associated with heartburn, diarrhea, and bloating, while underweight status was associated with nausea, vomiting, and abdominal pain. No association between BMI and constipation was found.

The Prevalence of Barrett's Esophagus Among a Saudi Arabian Population

BACKGROUND

While gastroesophageal reflux disease (GERD) is common in Middle Eastern countries, little data exists on the epidemiology of Barrett's esophagus (BE).

AIMS

We aimed to determine the prevalence of BE among patients undergoing esophagogastroduodenoscopy (EGD) in a cohort of Saudi patients.

METHODS

We retrospectively reviewed the endoscopy database at an academic tertiary care center. Consecutive adult patients who underwent an EGD for any indication between May 2014 and December 2018 were included. The prevalence of both endoscopically and histologically reported BE was determined. Multivariate regression analysis was used to identify factors associated with BE.

RESULTS

A total of 2805 patients were included. The mean age was 48 years (± 18.6) and 38.7% were male patients. BE was reported endoscopically in 18 (0.64%) and confirmed histologically in 9 patients (0.32%). Among patients with endoscopically reported BE, the mean age was 50.3 (± 16.1) years and 13 (72.2%) were male patients. Of patients with BE, short-segment BE was reported in 14 (77.8%) patients. Among the 9 patients with histologically confirmed BE; only one patient had dysplastic BE. On univariate analysis, BE was associated with male gender (p < 0.01), but not with age > 50, hiatal hernia, obesity or EGD performed for GERD related indications. On multivariate regression analysis, male gender was the only factor associated with BE (aOR 3.77, 95% CI 1.39-11.97, p = 0.01).

CONCLUSION

BE was endoscopically reported in 0.64% and histologically confirmed in 0.32% of this cohort of Saudi patients. Male gender was the only factor associated with BE.

Prevalence and factors associated with gastroesophageal reflux disease among primary health care attendants at Abha city, southwestern Saudi Arabia

BACKGROUND

Gastroesophageal reflux disease (GERD) is an abnormal reflux of the gastric content into the esophagus. In Saudi Arabia the GERD prevalence is not recently well studied.

OBJECTIVE

To investigate the prevalence of gastroesophageal reflux disease and associated factors among attendants of primary health care centers (PHCCs) at Abha city, Saudi Arabia.

METHOD

A descriptive cross- sectional study was performed using GerdQ as diagnostic tool for the GERD. The GerdQ consisted of six questions. Four questions were about the positive GERD predictors. The other two questions were about the negative GERD predictors. The scoring of GerdQ relies on the frequency of GERD symptoms during the last seven days. Using stratified random sample technique a representative sample was slected from the study PHCCs taking into conmsideration the relative catchment population in each center among adult males and females attending the selected PHCCs for any reason.

RESULTS

The present study included 320 persons. The study showed a prevalence of GERD of 67.8%. The prevalence of GERD with high impact on daily life (HIDL) was found to be 50%. By multiple logistic regression (enter method) only four significant independent factors associated with GERD were identified; being unmarried (aOR = 1.85, 95% CI:1.02-3.23); smoking (aOR = 2.11, 95% CI: 1.41-5.98), fast food intake (OR = 1.28, 95% CI:1.01-1.71), and subjective perception of stress (OR = 3.0, 95% CI:1.68-5.26).

CONCLUSIONS

GERD is a public health problem among adults in the region. Community level awareness programs are recommended. Healthcare providers must be aware of community perceptions and practices.

Gastroesophageal Reflux Disease

This chapter discusses a gastroesophageal reflux disease (GERD) case. GERD is a common disorder affecting the gastrointestinal tract. It results from the relaxation of the lower esophageal sphincter, which leads to stomach acid reflux, which in turn causes heartburn and discomfort. Certain lifestyle factors and dietary choices aggravate this condition, leading to serious tissue damage. Management of GERD usually requires medications and lifestyle and dietary modifications. This case involves the symptoms and aggravating factors of GERD. It also shows the role of medical nutrition therapy in managing GERD symptoms. Moreover, it will allow dietetic professionals to assess GERD symptoms to plan for nutrition interventions and educate patients about the dietary manipulation required to reduce gastric acid secretions and relieve pain.

Upper gastrointestinal bleeding: Causes and patient outcomes

BACKGROUND

Upper gastrointestinal bleeding (UGIB) remains a healthcare burden and is associated with considerable morbidity and mortality. We aim to describe the presentation, clinical, and laboratory characteristics of patients presenting with UGIB as well as important patient outcomes.

METHODS

This is a retrospective study performed at a tertiary care university hospital in Riyadh. Electronic endoscopic reports of patients undergoing gastroscopies for the indication of UGIB from January 2006 to January 2015 were included. Demographic data, past medical conditions, medications used, symptoms on presentation, as well as the patients' hemodynamic status, laboratory investigations on presentations, the need for blood products, the need for admission to an intensive care unit, rebleeding, and in-hospital mortality rates were retrieved from medical records.

RESULTS

Two hundred fifty-nine patients were included with a mean age of 57.1 years and males constituted 66.8% of the study cohort. At least one comorbidity was present in 88.2%, while 20.7% had a history of prior UGIB, 12.6% had a history of peptic ulcer disease, and 9.2% had known esophageal varices. A nonvariceal source represented 80.1% of the causes (95% CI: 75.4 to 85.3%), 15.5% required admission to the intensive care unit (ICU), the rebleeding rate was 8.9% (95% CI; 5.7% to 12.2%) while the in-hospital mortality was 4.4% (95% CI; 2.4% to 6.9%). The mean pre-endoscopic Rockall score was 2.6 (range: 0 to 5), while the total Rockall score was 4.4 (range: 1 to 9). There was no association between the pre-endoscopic Rockall score and rebleeding (3.0 vs. 2.5, P = 0.27) or need for ICU admission (3.2 vs. 2.4, P = 0.08), the total Rockall score and rebleeding (5.0 vs. 4.4, P = 0.58) or need for ICU admission (5.0 vs. 4.3, P = 0.36).

CONCLUSION

Causes of UGIB in this patient population were predominantly nonvariceal and the rebleeding and mortality rates resembled those of other studies.

Prevalence and severity of dyspepsia in Saudi Arabia: A survey-based study

Background and aim

Dyspepsia is one of the gastrointestinal diseases that is very common worldwide. Despite its prevalence globally, which ranges between 1.8% and 57%, no study has assessed the prevalence in Saudi Arabia. This study was aimed to investigate the prevalence and severity of dyspepsia in the general population of Saudi Arabia.

Methods

A modified Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was utilized to conduct our study. The questionnaire score ranges between 0 and 32, where zero indicated no dyspepsia, a score of 1–8 indicated mild dyspepsia, a score of 9–15 indicated moderate dyspepsia and a score of higher than 15 represented severe dyspepsia. Socio-demographic data of the participants including age, gender, marital status, BMI, job description, insurance, and education level were collected. Using Statistical Package for Social Sciences version 21.0 (SPSS), a univariate analysis was performed to assess the association of participants characteristics with the prevalence of dyspepsia, whereas logistic regression analysis was used to correlate their characteristics with the severity of dyspepsia.

Results

During a period of one month, March 1st to 31st 2019, a total of 778 participants have completed the survey. Most of them were females accounting for 68% of the population, married (63.9%), middle aged (range 34–51 years old) and literate with high school education (72.3%). Ninety two percent (92%) of the study population were found to experience dyspepsia. However, there is no significant association between socio-demographic characteristics and dyspepsia or its severity as well.

Conclusion

The prevalence of dyspepsia in Saudi Arabia is the highest in the gulf region which would potentially lead to more GI complications, and associate to poor health and economic outcomes. Education programs are essential to raise the people awareness of dyspepsia and the appropriate ways to prevent it.

The Determinants of the Quality of Life of Gastroesophageal Reflux Disease Patients Attending King Saud University Medical City

Background

Gastroesophageal reflux disease (GERD) is a common gastrointestinal (GI) tract disease and has an adverse effect on the quality of life (QoL) of patients. Studies on the QoL of GERD patients would increase awareness among healthcare providers about the magnitude of the problem and how to manage it.

Objectives

This study aimed to determine the essential variables that affected the QoL of GERD patients at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia.

Method

This was a cross-sectional study performed using quantitative questionnaires, which was conducted at KSUMC during the period from September 1, 2019, to April 1, 2020. We used the gastroesophageal reflux disease health-related quality of life (GERD-HRQL) questionnaire. Additionally, the authors collected information about sociodemographic variables and concomitant diseases from each participant.

Results

The study included 200 participants; 58.5% of them were males. Around 34.9% of participants in the age group A (18-34 years) had poor QoL compared to 57.5% and 50% of participants from the counterpart groups, respectively. There was a statistically significant difference in the QoL among various age groups (p: 0.006). Furthermore, 58.9% of obese participants had poor QoL; there was a statistically significant difference in the QoL between normal-weight and obese groups (p: 0.013).

Conclusion

The QoL of GERD patients was found to be affected negatively by increasing age and high body mass index (BMI). None of the other demographic variables and concomitant diseases had any significant effect on the QoL of the participants.

Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis

Although gastro-oesophageal reflux disease (GORD) is a common medical complaint, there is currently no consensus on the global prevalence of GORD. The aim of this study was to conduct a systematic review and meta-analysis on GORD prevalence and risk factors at a global level. MEDLINE, EMBASE, CINAHL, Scopus, Cochrane library, and Google Scholar were systematically searched, without language restrictions, for studies on the prevalence and risk factors of GORD. Data were pooled using a random effects model (95% confidence interval), and the odds ratio and relative risk for each risk factor were calculated. Out of 34,355 search results, 96 records reporting the results from 102 studies fulfilled the inclusion criteria, representing 37 countries and all regions of the UN geoscheme. The global pooled prevalence of GORD was 13.98% and varied greatly according to region (12.88% in Latin America and the Caribbean to 19.55% in North America) and country (4.16% in China to 22.40% in Turkey). Using the United Nations 2017 Revision of World Population Prospects, the estimated number of individuals suffering from GORD globally is 1.03 billion. Multiple risk factors associated with a significant increase in the risk of GORD were also identified. This systematic review and meta-analysis revealed that although a substantial proportion (13.98%) of the global population suffers from GORD, there are significant variations between regions and countries. Risk factors for GORD were also identified which may allow clinicians to recognise individuals most at risk.

Risk assessment of obstructive sleep apnea among gastroesophageal reflux disease patients in Taif, Saudi Arabia

Background:

Previous studies have reported the association between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA).

Objectives:

The aim of the present study was to assess the prevalence of GERD among Saudi population, and to determine the risk of OSA among those diagnosed with GERD in Taif city of Saudi Arabia.

Materials and Methods:

A cross-sectional online survey was done among 843 Saudi participants using a questionnaire by collecting demographic data, weight, height, blood group, and having a previous nose or throat surgery. The GERD questionnaire and the sleep apnea symptom index were used to determine GERD and OSA prevalence.

Results:

The prevalence of GERD and OSA was 17.6% and 2.4%, respectively. A significantly higher prevalence of GERD was found among males, those with age >50 years, employees and obese participants, and those having OSA. Participants with an age >50 years and males, had a significantly higher prevalence of OSA. Being a male and older age were predictors for GERD, and the presence of GERD was an independent predictors for OSA.

Conclusion:

Future population-based studies including a representative sample of the population should be done to confirm the revealed association between GERD and OSA. It is necessary to assess GERD in patients with OSA in clinical practice.

Prevalence of gastro-esophageal reflux in diabetic patients at a tertiary hospital in Central Saudi Arabia

Objectives:

To estimate the prevalence of gastro-esophageal reflux disease (GERD) among diabetic patients and to investigate GERD’s potential association with diabetic complications, and patients’ sociodemographic and clinical characteristics.

Methods:

This cross-sectional study used the GERD questionnaire (GerdQ) in 403 diabetic patients attending the outpatient clinics at King Khalid University Hospital, King Saud University Medical City, King Saud University; a tertiary hospital in Riyadh, Saudi Arabia, between January and February 2019. On the basis of a cutoff GerdQ score of 8, we distinguished GERD and non-GERD groups.

Results:

Gastro-esophageal reflux disease prevalence was 44.9%. Of the diabetic patients with GERD, 76.8% were female (p<0.001). Gastro-esophageal reflux disease patients were older (mean age: 55.27, p=0.038) and had a slightly higher body mass index (BMI) than non-GERD (32.04 versus, 30.20 p=0.006), respectively. Smokers in the GERD group were 1.7% versus 7.2% in the non-GERD group (p=0.007). Peripheral numbness (p=0.023) and nephropathy (p=0.041) were more prevalent in patients with GERD, while myocardial infarction was more prevalent in non-GERD subjects (p=0.038). On multi variable analysis, the only independent GERD risk factors were female gender (p=0.013) and age >65 years (p=0.007).

Conclusion:

Gastro-esophageal reflux disease prevalence in diabetic patients was 45%. Diabetic patients with GERD were more often female and older >65 years. None of the other tested factors (BMI, smoking status, diabetes mellitus duration, therapeutic plan, or diabetic complications) showed significant difference between GERD and non-GERD groups.

Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Southwestern Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders that has substantial health and economic consequences. Several modifiable risk factors are associated with GERD, hence we conducted the present study to assess the prevalence and risk factors of GERD in a previously understudied population of southwestern Saudi Arabia.

Methods

A cross-sectional study was carried out to calculate the prevalence of GERD and assess its risk factors. A structured self-administered questionnaire was distributed on a random sample of 853 participants from Jazan region, Saudi Arabia. The questionnaire consisted of questions on the participants’ sociodemographic and lifestyle characteristics. The presence of GERD was detected using the GERD questionnaire (GerdQ). Data were analyzed using descriptive statistics and chi-square test, with a significance level of P < 0.05 or P < 0.01.

Results

The study included 853 participants; 69.1% males and 30.9% females. The proportion of participants who scored >8 on the GerdQ (had GERD) was 32.2%. GERD was associated with age (P < 0.01), marital status (P < 0.01), employment status (P < 0.01), fast food intake (P < 0.01), analgesics use (P < 0.01), and smoking (P < 0.01). GERD was more common among Khat chewers compared to non-Khat chewers (P < 0.05) and showed a significant association with the frequency of Khat use.

Conclusion

The results show a high prevalence of GERD in the general population of Southwestern Saudi Arabia. Several sociodemographic and lifestyle characteristics were associated with the disease.

Personal, academic and stress correlates of gastroesophageal reflux disease among college students in southwestern Saudi Arabia: A cross-section study

Background

Gastroesophageal reflux disease (GERD) is a worldwide prevalent gastrointestinal disorder which has negative impacts on quality of life, health and economy. The aims of this study were to assess the prevalence of GERD among college students in southwestern Saudi Arabia and to evaluate its personal, academic and stress correlates.

Materials and methods

Through a cross-sectional study design, a self-reported questionnaire was distributed between a representative sample of students in health and non-health care colleges in southwestern Saudi Arabia. The questionnaire included data for personal characteristics, academic study, and Arabic versions of GERD questionnaire (GerdQ) and Cohen's Perceived Stress Scale.

Results

Out of 2878 studied students, GERD was reported by 28.6% and 36.6% of students in health and non-health care colleges respectively with an overall prevalence rate of 33.18%. It was associated with impacts on daily life in 17.2% of students. By multivariable regression analysis, GERD was significantly higher among males (aOR = 1.44, 95% CI:117–1.65), ex-smokers (aOR = 1.87), current smokers (aOR = 1.71), non-health care students (aOR = 1.36) and those exposed to high perceived stress (aOR = 1.30).

Conclusion

GERD is a prevalent problem among college students in southwestern Saudi Arabia as it affects about one third of the students. Considering high prevalence of GERD, associated daily life impacts, young age of the studied subject and the risk of future complications, this condition could represent a challenging health and economic problem. The risk of GERD is higher among; males, smokers, former smokers, non-health care colleges students and subjects exposed to high perceived stress.

•

GERD affects about one third of college students in southwestern Saudi Arabia.

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GERD is associated with daily life impacts in about one fifth of the students.

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GERD could represent a challenging health and economic problem.

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GERD is significantly associated with high perceived stress.

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Risk of GERD is higher among male students, smokers and non-health care students.

Gastro-oesophageal reflux disease symptoms and associated risk factors among medical students, Saudi Arabia

Background and aims

Gastro-oesophageal reflux disease (GERD) is a common gastrointestinal disease worldwide that is associated with impaired quality of life and higher risk of complications. The identification of risk factors is necessary for preventive measures. The aim of this study is to evaluate the prevalence of GERD symptoms as well as its relation to body mass index (BMI) and other risk factors among medical students of Jeddah and Rabigh branches, King Abdul-Aziz University, Saudi Arabia.

Subjects and methods

A cross-sectional study was conducted at the Faculty of Medicine in Rabigh, King Abdul-Aziz University, Saudi Arabia. The study included 197 medical students from Rabigh and Jeddah branches of the university. The study employed a Gastroesophageal Reflux Disease Questionnaire which is derived from a self-administered validated GERD questionnaire (GerdQ).

Results

The prevalence of GERD symptoms was 25.9%. The most frequent symptoms were regurgitation and burning sensation. High BMI, family history, energy drinks and fried food were found to be statistically significant risk factors (p<0.05) by univariate analysis. However, the logistic regression for the prediction of GERD symptoms among medical students showed that only family history had a significant correlation (p<0.05).

Conclusion

GERD symptoms were common in medical students of King Abdulaziz University, Saudi Arabia. Family history was found to be a significant predictor of GERD symptoms. Effective educational strategies for groups with significant risk factors of GERD need to be implemented.

Prevalence and factors associated with gastroesophageal reflux disease in southern India: A community-based study

BACKGROUND AND AIM

Gastroesophageal reflux disease (GERD) is common worldwide with significant expenditure for health care. Community-based data on the prevalence of GERD in India remains scarce. This study was conducted to determine the prevalence of GERD and to identify potential associations.

METHODS

A community-based survey of adults (aged ≥18 years) was done through population proportionate to size sampling in urban and rural areas of Vellore district, Tamil Nadu, India. GERD was defined as heartburn and regurgitation occurring at least twice per week. Associations between GERD and gender, age, anthropometric measures, and consumption of tobacco, alcohol, meat, and milk were evaluated. Odds ratios (OR) with 95% confidence intervals were derived from logistic regression models.

RESULTS

Of 6174 participants (3157 urban, 2599 male), 8.2% had GERD. The prevalence was higher in urban (11.1%) compared to rural areas (5.1%) (p < 0.001). Among patients with GERD, 34.3% used medications daily for symptom relief. On univariate analysis, GERD was associated with female gender, living in an urban area, age >30, BMI >25, and infrequent milk consumption. On multivariate analysis, female gender (OR 1.3; 95% CI 1.1-1.6), living in urban area (OR 2.3; 95% CI 1.9-2.8), age >30 years (OR 1.9; 95% CI 1.4-2.5), BMI ≥ 25 kg/m² (OR 1.3; 95% CI 1.1-1.6), and infrequent milk intake (OR 1.6; 95% CI 1.3-1.9) were independently associated with GERD.

CONCLUSION

Symptomatic GERD was found in 8.2% of respondents in this representative southern Indian community, being more prevalent in urban residents, women, older, and obese individuals.

Prevalence and Predictors of Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy

BACKGROUND AND AIMS

Laparoscopic sleeve gastrectomy (LSG) might be associated with a new onset or worsening of gastroesophageal reflux disease (GERD). We aim to evaluate the prevalence of post-LSG GERD symptoms and its predictors.

METHODS

We included patients who underwent primary LSG at a university hospital from 2009 to 2015. We used the GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire and included questions regarding regurgitation to evaluate symptoms before and after LSG; each item was scored from 1 to 5 based on the symptom severity.

RESULTS

A total of 213 patients (mean age, 36.08 ± 10.22 years; 48.36% were men) were included. The mean preoperative body mass index (BMI) was 47.84 kg/m², mean percent total weight loss was 37.99% (95% CI, 36.64 to 39.34), mean percent excess weight loss was 84.14% (95% CI, 80.91 to 87.36), and the mean percent excess BMI loss was 84.17% (95% CI, 80.94 to 87.41). The mean heartburn score while standing increased (0.71 vs. 1.09, p < 0.01) as well as the score of heartburn requiring a diet change (0.67 vs. 1.16, p < 0.01) post-LSG. The scores for dysphagia, odynophagia, and regurgitation increased. New-onset heartburn was reported in 47.06% of our cohort. Those with high preoperative BMIs were less likely to develop new-onset or worsening symptoms of GERD (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95-0.99). More severe heartburn symptoms while standing were associated with higher risks of developing or worsening GERD symptoms (OR, 1.22; 95% CI, 1.01-1.47). None of the other variables could predict the development or worsening of the GERD symptoms.

CONCLUSION

Symptoms of heartburn and regurgitation are common after LSG; however, none of the variables preoperatively could strongly predict patients who would develop new onset or experience worsening of symptoms postoperatively.

Review of Non-Respiratory, Non-Cancer Physical Health Conditions from Exposure to the World Trade Center Disaster

After the World Trade Center attacks on 11 September 2001 (9/11), multiple cohorts were developed to monitor the health outcomes of exposure. Respiratory and cancer effects have been covered at length. This current study sought to review the literature on other physical conditions associated with 9/11-exposure. Researchers searched seven databases for literature published in English from 2002 to October 2017, coded, and included articles for health condition outcome, population, 9/11-exposures, and comorbidity. Of the 322 titles and abstracts screened, 30 studies met inclusion criteria, and of these, 28 were from three cohorts: the World Trade Center Health Registry, Fire Department of New York, and World Trade Center Health Consortium. Most studies focused on rescue and recovery workers. While many of the findings were consistent across different populations and supported by objective measures, some of the less studied conditions need additional research to substantiate current findings. In the 16 years after 9/11, longitudinal cohorts have been essential in investigating the health consequences of 9/11-exposure. Longitudinal studies will be vital in furthering our understanding of these emerging conditions, as well as treatment effectiveness.

Prevalence of Gastroesophageal Reflux Disease in Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal tract disease. The incidence is higher in Asian and Arab countries. In Saudi Arabia, there are few studies that have assessed the prevalence of GERD among some cities' communities. Hence, this study aims to study the prevalence of GERD among the general population of Saudi Arabia.

Methods

A cross-sectional study was designed to determine the prevalence of GERD among the community of Saudi Arabia. The sample was randomly gathered through self-administered validated GERD questionnaire (GerdQ) to diagnose GERD, during the period from November to December 2016. The sociodemographic data was assessed for all participants. The data were analysed using Statistical Package for Social Sciences version 21.0 (SPSS); the t-test was used to assess the association of GERD and sociodemographic data.

Results

The sample was comprised of 2,043 participants. Female and male were 51.8% and 48.2%, respectively. Mean age was 29.6 years with the standard deviation of 10.5 years. The GERD prevalence was 28.7%. It was found statistically significant among divorced/widow (34.9%, P = 0.003). In contrast, there was no association between GERD's prevalence and gender, age, residence status, education level, occupation, and blood group (P > 0.05).

Conclusions

The prevalence of GERD among Saudi population is higher than that in Western countries and East Asia. It affects divorced/widow, obese and those with a sedentary lifestyle. It is advocated that national programs and educational campaigns for prevention of this disease and its complications should be established.

Risk Factors for Gastroesophageal Reflux Disease in Saudi Arabia

Background

Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal tract diseases worldwide. GERD has an effect on the patients' quality of life as well as the health care system that can be prevented by identifying its risk factors among the population. Hence, we applied this study to assess the GERD's risk factors in Saudi Arabia.

Methods

A cross-sectional study was designed to assess the GERD's risk factors among the community of Saudi Arabia. The sample was collected randomly during the period from November to December 2016. Through a self-administered validated GERD questionnaire (GerdQ), GERD was diagnosed. Then, the GERD's risk factors were assessed among all participants. The data were analyzed using Statistical Package for Social Sciences version 21.0; the Student's t-test was used to assess the association of GERD and risk factors.

Results

A total of 2,043 subjects participated in the study. The characteristics and behaviors of participants statistically significant with GERD were positive family history (39.3%), obese (body mass index > 30 kg/m²) (39.4%), not performing weekly regular physical activities ≥ 30 min (31.1%) and smoking (39.3%). GERD was commonly noticed in participants on analgesics (38.4%), not taking fibers (37.4%), drinking tea (33.4%), eating greasy (31.2%) and fast food (32.7%), and these were statistically significant with GERD (P ≤ 0.05).

Conclusion

The characteristics and behaviors associated with GERD in Saudi population are family history of GERD, obesity, sedentary lifestyle and smoking. Other common risk factors correlated with GERD are analgesics intake, no fibers intake, drinking tea, greasy and fast food intake.

Gastroesophageal reflux disease prevalence among school teachers of Saudi Arabia and its impact on their daily life activities

BACKGROUND

Gastroesophageal reflux disease (GERD) is the most common upper gastrointestinal disorder encountered in the elderly patient. It is highly prevalent worldwide with a prevalence of 10-20% in the western world. The health-related quality of life (HRQL) is lower in individuals with GERD than in the general population and is comparable to that in individuals with other chronic diseases. It has a considerable impact on the quality of the patient's life through its symptoms and economically by following consultation procedures and medical care. A few studies have been done in Saudi Arabia using general population as subject and have reported a very high prevalence.

OBJECTIVE

(1) Estimation of gastro GERD prevalence among school teachers in Qassim region. (2) To assess the impact of GERD symptoms on teacher's daily life activity. (3) To compare prevalence and risk factors of GERD between age-groups and gender.

METHODOLOGY

A cross-sectional study that was conducted among 200 school teachers selected by multi-stage stratified random sample method in Qassim region during 2015. A reliable and valid self-administered GERD questionnaire for diagnosis of GERD was used. GERD-HRQL questionnaire was used to assess the impact of GERD on the patient's life quality. Data were analyzed using Statistical Package for Social Sciences Version 20.0; Chi-square was used to test the association between GERD and sociodemographic data.

RESULTS

The total number of the participants was 200 with an equal male to female ratio. 55% (116/200) of the participants reported with GERD. 53 point 5% of these (62/116) were female and 46.6% (54/116) were male. The commonest age group was 31-40 years with 45.5% (91/200) participants. 13/200 (6.5%) participants were smokers, of which only 15.9% were female. 41 point 3% (48/116) of the GERD +ve participants were having blood group O +ve 7.8% (9/116) of GERD participants reported symptoms which affected their daily life activity.

CONCLUSION

This study revealed a prevalence of GERD symptoms among 58% of school teachers. 7 point 8% of GERD participants reported symptoms which affected their daily life activities. These data indicate a need for a comprehensive approach to managing the GERD and related diseases and a more intensified level of awareness about GERD symptoms and its complications. In addition, a health care and preventive measure may be implemented to tackle the problem among school teachers.

The association between body mass index and gastroesophageal reflux disease in the World Trade Center Health Program General Responder Cohort

BACKGROUND

There is increasing concern about the obesity epidemic in the United States. Obesity is a potential risk factor for a number of chronic diseases, including gastroesophageal reflux disease (GERD). This analysis examined whether body mass index (BMI) was associated with physician-diagnosed GERD in World Trade Center (WTC) general responders.

METHODS

19,819 WTC general responders were included in the study. Cox proportional hazards regression models were used to compare time to GERD diagnosis among three BMI groups (normal (<25 kg/m(2) ), overweight (≥25 and <30 kg/m(2) ), and obese (≥30 kg/m(2) )).

RESULTS

Among the responders, 43% were overweight and 42% were obese. The hazard ratio for normal versus overweight was 0.81 (95% Confidence Interval (CI), 0.75-0.88); normal versus obese 0.71 (95%CI, 0.66, 0.77); and overweight versus obese 0.88 (95%CI, 0.83-0.92).

CONCLUSION

GERD diagnoses rates were higher in overweight and obese WTC responders. Am. J. Ind. Med. 59:761-766, 2016. © 2016 Wiley Periodicals, Inc.

Zero-Inflated Models for Identifying Relationships Between Body Mass Index and Gastroesophageal Reflux Symptoms: A Nationwide Population-Based Study in China

BACKGROUND AND AIM

That obesity leads to gastroesophageal reflux is a widespread notion. However, scientific evidence for this association is limited, with no rigorous epidemiological approach conducted to address this question. This study examined the relationship between body mass index (BMI) and gastroesophageal reflux symptoms in a large population-representative sample from China.

METHODS

We performed a cross-sectional study in an age- and gender-stratified random sample of the population of five central regions in China. Participants aged 18-80 years completed a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire. The zero-inflated Poisson regression model estimated the relationship between body mass index and gastroesophageal reflux symptoms.

RESULTS

Overall, 16,091 (89.4 %) of the 18,000 eligible participants responded. 638 (3.97 %) and 1738 (10.81 %) experienced at least weekly heartburn and weekly acid regurgitation, respectively. After adjusting for potential risk factors in the zero-inflated part, the frequency [odds ratio (OR) 0.66, 95 % confidence interval (95 % CI) 0.50-0.86, p = 0.002] and severity (OR 0.66, 95 % CI 0.50-088, p = 0.004) of heartburn in obese participants were statistically significant compared to those in normal participants. In the Poisson part, the frequency of acid regurgitation, overweight (OR 1.10, 95 % CI 1.01-1.21, p = 0.038) and obesity (OR 1.19, 95 % CI 1.04-1.37, p = 0.013) were statistically significant. BMI was strongly and positively related to the frequency and severity of gastroesophageal reflux symptoms. Additionally, gender exerted strong specific effects on the relationship between BMI and gastroesophageal reflux symptoms.

CONCLUSIONS

The severity and frequency of heartburn were positively correlated with obesity. This relationship was presented distinct in male participants only.