A population-based study on prevalence and risk factors of gastroesophageal reflux disease in the Tibet Autonomous Region, China

Associations of the timing of sleep and meals with the presence of gastroesophageal reflux disease in community-dwelling women in Japan

BACKGROUND

It has been suspected that circadian rhythms may play a part in the pathogenesis of gastrointestinal diseases including gastroesophageal reflux disease (GERD). The present study aimed to examine the cross-sectional association of the timing of sleep and meals with the presence of GERD in community-dwelling women in Japan.

METHODS

In total, 605 women responded to a self-administered questionnaire asking for information on GERD symptoms, sleep habits, sleep disturbances and the timing of meals. GERD symptoms were evaluated using the Frequency Scale for the Symptoms of GERD, and participants with a score of more than seven points were classified as having GERD.

RESULTS

In total, 104 (17.2%) women were found to have GERD. Later bedtime on both weekdays and weekends and later midpoint of sleep were significantly associated with the odds ratios (OR) of GERD after controlling for covariates: ORs for each 1 h delay were 1.31 (95% confidence interval [CI] = 1.03-1.68), 1.38 (95% CI = 1.08-1.75) and 1.43 (95% CI = 1.06-1.95). Having lunch at irregular times was significantly associated with the increased OR of GERD (1.99; 95% CI = 1.02-3.91). Longer overnight fasting duration and longer time intervals from the midpoint of sleep to breakfast and lunch were significantly associated with decreased OR of GERD (ORs for each 1 h increase were 0.73 [95% CI = 0.56-0.95], 0.64 [95% CI = 0.46-0.88] and 0.70 [95% CI = 0.51-0.96]).

CONCLUSIONS

These data suggest that the timing of sleep and timing of meals relative to the sleep/wake cycle are associated with the presence of GERD.

Gastroesophageal reflux disease symptoms and associated factors among university students in Amhara region, Ethiopia, 2021: a cross-sectional study

INTRODUCTION

Gastroesophageal reflux disease (GERD) symptom is a relapsing chronic medical condition resulting from the reflux of gastric acid contents into the esophagus and throat or mouth. It interferes with social functioning, sleep, productivity, and quality of life. Despite this, the magnitude of GERD symptoms is not known in Ethiopia. Therefore, this study was conducted to determine the prevalence and associated factors of GERD symptoms among university students in the Amhara national regional state.

METHODS

An institutional-based cross-sectional study was employed in Amhara national regional state Universities, from April 1, 2021, to May 1, 2021. Eight hundred and forty-six students were included in the study. A stratified multistage sampling technique was employed. Data were collected by using a pretested self-administered questionnaire. Data were entered via Epi Data version 4.6.0.5 and analyzed by SPSS version-26 software. The bivariable and multivariable binary logistic regression analyses were used to determine the associated factors of GERD symptoms. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated. Variables having a p-value of ≤ 0.05 were considered statistically significant.

RESULTS

The prevalence of GERD symptoms in this study was 32.1% (95% CI = 28.7-35.5%). Being in the age of 20-25 years (AOR = 1.74, 95%CI = 1.03-2.94), female (AOR = 1.67, 95% CI = 1.15-2.41), use of antipain (AOR = 2.47, 95% CI = 1.65-3.69) and soft drinks (AOR = 1.58, 95% CI = 1.13-2.20) were significantly associated with higher odds of GERD symptoms. Urban dwellers had less chance of having GERD symptoms (AOR = 0.67, 95% CI = 0.48-0.94).

CONCLUSION

Nearly one-third of university students are affected by GERD symptoms. Age, sex, residence, use of antipain, and consumption of soft drinks were significantly associated with GERD. Reducing modifiable risk factors such as antipain use and soft drink consumption among students is advisable to decrease the disease burden.

Prevalence, General and Periodontal Risk Factors of Gastroesophageal Reflux Disease in China

Purpose

There is insufficient information about the prevalence and risk factors of gastroesophageal reflux disease (GERD) in the Chinese adult population. We aimed to assess the prevalence and identify the risk factors of GERD in China.

Methods

We collected data from a nationally representative sample (50,991 subjects) of Chinese adults from a large nation-wide cross-sectional survey. GERD was diagnosed by a standardized Chinese-language GERD questionnaire with a score of ≥ 8. The demographic characteristics, comorbidities and periodontal factors of all participants were collected.

Results

Fifty-thousands-one-hundred-eighty-three participants were finally included in this study. The overall prevalence of GERD was 5.6% (95% CI, 5.4-5.8%) among the general Chinese population aged 20 years or older. Women, smokers, and people with older age, BMI ≥ 25.0 kg/m², urban residence, lower education level or comorbidities were more prevalent with GERD (p < 0.001). Symptoms of severe periodontitis (OR = 1.40, 95% CI 1.28-1.52, p < 0.001) and lower frequency of tooth brushing (OR = 2.01, 95% CI 1.76-2.29, p < 0.001) were significantly associated with risk of GERD.

Conclusion

Symptom-based GERD is highly prevalent in the Chinese population. Overweight and smoking are major preventable risk factors for GERD. Periodontal factors are novel potential risk factors for GERD and should be given more attention in GERD prevention.

Dietary and Lifestyle Factors Related to Gastroesophageal Reflux Disease: A Systematic Review

We performed this review to clarify which dietary and lifestyle factors are related to gastroesophageal reflux disease. Through a systematic search of the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature (CBM) databases, we identified articles with clear definitions of GERD, including nonerosive gastroesophageal reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), that included dietary and lifestyle factors as independent factors affecting the onset of GERD (expressed as odds ratios (ORs) or relative risks (RRs) and 95% confidence intervals (CIs)). Due to heterogeneity among the studies, we used descriptive statistical analyses to analyze and synthesize each outcome based on the disease type. In total, 72 articles were included, conducted in ten Western countries (26 articles in total) and nine Eastern countries (46 articles in total). We categorized dietary factors into 20 items and lifestyle factors into 11 items. GERD is related to many irregular dietary and lifestyle habits (such as a habit of midnight snacking: OR=5.08, 95% CI 4.03–6.4; skipping breakfast: OR=2.7, 95% CI 2.17–3.35; eating quickly: OR=4.06, 95% CI 3.11–5.29; eating very hot foods: OR=1.81, 95% CI 1.37–2.4; and eating beyond fullness: OR=2.85, 95% CI 2.18–3.73). Vegetarian diets (consumption of nonvegetarian food (no/yes); OR=0.34, 95% CI 0.211–0.545) and no intake of meat (OR=0.841, 95% CI 0.715–0.990) were negatively related to GERD, while meat (daily meat, fish, and egg intake: OR=1.088, 95% CI 1.042-1.135) and fat (high–fat diet: OR=7.568, 95% CI 4.557–8.908) consumption were positively related to GERD. An interval of less than three hours between dinner and bedtime (OR=7.45, 95% CI 3.38–16.4) was positively related to GERD, and proper physical exercise (physical exercise >30 minutes (>3 times/week): OR=0.7, 95% CI 0.6–0.9) was negatively correlated with GERD. Smoking (OR=1.19, 95% CI 1.12–1.264), alcohol consumption (OR=1.278, 95% CI 1.207–1.353) and mental state (poor mental state: OR=1.278, 95% CI 1.207–1.353) were positively correlated with GERD. RE (vitamin C: OR=0.46, 95% CI=0.24–0.90) and BE (vitamin C: OR=0.44,95% CI 0.2-0.98; vitamin E: OR=0.46, 95% CI 0.26–0.83) were generally negatively correlated with antioxidant intake. In conclusion, many dietary and lifestyle factors affect the onset of GERD, and these factors differ among regions and disease types. These findings need to be further confirmed in subsequent studies.