Skip to main content
SpringerLink
Log in

Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in Northern India

  • Original Article
  • Published:
Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background and aims

Gastroesophageal reflux disease (GERD) is considered to be a common and chronic gastrointestinal disorder. The prevalence of GERD is believed to be less in Asia than in Western countries. Population-based data on GERD are lacking from India. The present study aimed at determining the prevalence of GERD symptoms in an adult Indian community and the potential risk factors associated with GERD.

Methods

The study population consisted of all the employees of All India Institute of Medical Sciences, New Delhi. An interview-based observational study was done on the basis of an earlier validated questionnaire. The subjects were asked about the frequency and severity of heartburn and/or regurgitation experienced by them in the previous year. These symptoms were then scored from 0 to 18. Subjects with a score of at least 4 were considered to have symptomatic GERD. Association of GERD with factors like age, sex, BMI, Kuppuswamy social class index, smoking, alcohol, NSAID use, and comorbid illness was analyzed.

Results

A total of 4079 employees were interviewed in person on a 29-item questionnaire from June 2003 to January 2005. Of the 4039 eligible subjects, 653 (16.2%) had GERD; 3.6% had heartburn on daily basis and 5.9% on a weekly basis. The corresponding prevalences for regurgitation were 3.3% and 5.0%, respectively. One hundred and eight of 4039 (2.7%) had severe GERD symptoms. Higher BMI (OR = 1.90, 95% CI: 1.4–2.6 for BMI ≥ 25), current smoking (OR = 1.48, 95% CI: 1.19–1.83), asthma (OR = 3.13, CI: 2.06–4.76) and hypertension (OR = 1.71, 95% CI: 1.16–2.50) were associated with the presence of GERD symptoms.

Conclusions

Prevalence of GERD in an urban adult population from northern India is 16.2% which is similar to other industrialized countries. Higher body mass index, current smoking, and presence of asthma or hypertension predisposes to GERD in our population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Locke 3rd GR, Talley NJ, Fett SL, Zinsmister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population based study in Olmstead County, Minnesota. Gastroenterology. 1997;112:1448–56.

    Article  PubMed  Google Scholar 

  2. Dean BB, Crawley JA, Schmitt CM, Wong J, Ofman JJ. The burden of illness of gastro-esophageal reflux disease: impact on work productivity. Aliment Pharmacol Ther. 2003;17:1309–17.

    Article  PubMed  CAS  Google Scholar 

  3. Isolauri J, Laippala P. Prevalence of symptoms suggestive of gastro-esophageal reflux disease in an adult population. Ann Med. 1995;27:67–70.

    Article  PubMed  CAS  Google Scholar 

  4. Haque M, Wyeth JW, Stace NH, Talley NJ, Green R. Prevalence, severity and associated features of gastro-oesophageal reflux and dyspepsia: a population based study. N Z Med J. 2000;113:178–81.

    PubMed  CAS  Google Scholar 

  5. Diaz-Rubio M, Moreno-elola-olaso C, Rey E, Locke III GR, Rodrigues-Artalejo F. Symptoms of gastro-esophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther. 2004;19:95–105.

    Article  PubMed  CAS  Google Scholar 

  6. Goh KL, Chang SC, Fock KM, Ke MY, Park NJ, Lam JK. Gastro-oesopharyngeal reflux disease in Asia. J Gastroenterol Hepatol. 2000;15:230–8.

    Article  PubMed  CAS  Google Scholar 

  7. Rosaida MS, Goh KL. Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol. 2004;16:495–501.

    Article  PubMed  Google Scholar 

  8. Wong WM, Lai KC, Lam LF, et al. Prevalence, clinical spectrum and health care utilisation of gastro-oesophageal reflux disease in a Chinese population: a population based study. Aliment Pharmacol Ther. 2003;18:595–604.

    Article  PubMed  CAS  Google Scholar 

  9. Goh KL. Changing epidemiology of gastro-oesophageal reflux disease in the Asia-Pacific region: an overview. J Gastroenterol Hepatol. 2004;19:S22–5.

    Article  PubMed  Google Scholar 

  10. Ho KY, Lim LS, Goh WT, Lee JMJ. The prevalence of gastro-oesophageal reflux has increased in Asia: a longitudinal study in the community. J Gastroenterol Hepatol. 2002;16:A132.

    Google Scholar 

  11. Chitturi S, Farrel GC, George J. Non-alcoholic steatohepatitis in the Asia-pacific region: future shock. J Gastroenterol Hepatol. 2004;19:368–74.

    Article  PubMed  Google Scholar 

  12. Klauser AG, Schindlebect NE, Muller-Lissner A. Symptoms in gastro-oesophageal reflux disease. Lancet. 1990;335:205–8.

    Article  PubMed  CAS  Google Scholar 

  13. Locke III GR, Talley NJ, Fett SL, Zinsmeister AR, Mellton LJ. Risk factors associated with symptoms of gastro-oesophageal reflux. Am J Med. 1999;106:642–9.

    Article  PubMed  Google Scholar 

  14. Stanghellini V. Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors: results from the domestic/international gastroenterology surveillance study (DIGEST). Scand J Gastroenterol. 1999;231 Suppl:20–8.

    Article  CAS  Google Scholar 

  15. Mishra D, Singh HP. Kuppuswamy’s socioeconomic scale—a revision. Indian J Pediatr. 2003;70:273–4.

    Article  PubMed  CAS  Google Scholar 

  16. Madan K, Ahuja V, Gupta SD, et al. Impact of 24-h esophageal pH monitoring on the diagnosis of gastroesophageal reflux disease: defining the gold standard. J Gasteroenterol Hepatol. 2005;20:30–7.

    Article  Google Scholar 

  17. Vigneri S, Termini R, Leandro G, et al. A comparison of five maintenance therapies for reflux esophagitis. N Eng J Med. 1995;333:1106–10.

    Article  CAS  Google Scholar 

  18. Louis E, Delooze D, Deprez P, et al. Heartburn in Belgium: prevalence, impact on daily life, and utilization of medical resources. Eur J Gastroenterol Hepatol. 2002;14:279–84.

    Article  PubMed  Google Scholar 

  19. Valle C, Broqlia F, Pistorio A, et al. Prevalence and impact of symptoms suggestive of gastroesophageal reflux disease. Dig Dis Sci. 1999;44:1848–52.

    Article  PubMed  CAS  Google Scholar 

  20. Fujiwara Y, Higuchi K, Watanabe Y, et al. Prevalence of gastroesophageal reflux disease and gastroesophageal reflux disease symptoms in Japan. J Gastroenterol Hepatol. 2005;20:26–9.

    Article  PubMed  Google Scholar 

  21. Rajendra S, Alahuddin S. Racial differences in the prevalence of heartburn. Aliment Pharmacol Ther. 2004;19:375–6.

    Article  PubMed  CAS  Google Scholar 

  22. Pan GZ, Xu GM, Ke MY, et al. Epidemiological study of symptomatic gastro-esophageal reflux disease in China, Beijing and Shanghai. Chin J Dig Dis. 2000;1:2–8.

    Article  Google Scholar 

  23. Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population with particular sequence to reflux-type symptoms. Am J Gastroenterol. 1998;93:1816–22.

    Article  PubMed  CAS  Google Scholar 

  24. Khoshbaten M. Gastro-esophageal reflux disease in north-western Tabriz, Iran. Indian J Gastroenterol. 2003;22:138–9.

    PubMed  Google Scholar 

  25. Kang JY. Systematic review: geographical and ethnic differences in gastroesophageal reflux disease. Aliment Pharmacol Ther. 2004;20:705–17.

    Article  PubMed  CAS  Google Scholar 

  26. Ho KY, Kang JY, Seow A. Pattern of consultation and treatment for heartburn: findings from a Singapore community survey. Aliment Pharmacol Ther. 1999;11:1029–33.

    Article  Google Scholar 

  27. Wang JH, Luo JY, Dong L, Gong J, Ting M. Epidemiology of gastro-oesophageal reflux disease: a general population-based study in Xian of Northwest China. World J Gastroenterol. 2004;10:1647–51.

    PubMed  Google Scholar 

  28. Kennedy T, Jones R. The prevalence of gastro-oesophageal reflux symptoms in a UK population and the consultation behaviour of patients with these symptoms. Aliment Pharmacol Ther. 2000;14:1589–94.

    Article  PubMed  CAS  Google Scholar 

  29. Voutilainen M, Sippmen P, Meeklin JP, et al. Gastroesophageal reflux disease: prevalence, clinical, endoscopic and histopathological findings in 1128 consecutive patients referred for endoscopy due to dyspeptic and reflux symptoms. Digestion. 2000;61:6–13.

    Article  PubMed  CAS  Google Scholar 

  30. Lagergren J, Bergstrom R, Nyren O. No relation between body mass index and gastro-oesophageal reflux symptoms in a Swedish population based study. Gut. 2000;47:26–9.

    Article  PubMed  CAS  Google Scholar 

  31. Watanabe Y, Fujiwara Y, Shiba M, et al. Cigarette smoking and alcohol consumption associated with gastro-oesophageal reflux disease in Japanese men. Scand J Gastroenterol. 2003;38:807–11.

    Article  PubMed  CAS  Google Scholar 

  32. Rai RR, Sharma M. Prevalence and clinical spectrum of GERD in healthy population. Indian J Gastroenterol. 2004;23 suppl 2:A12.

    Google Scholar 

  33. Nelson M, Johnsen R, Ye W, Hveem K, Lagergren J. Life style related risk factors in the etiology of gastro-oesophageal reflux. Gut. 2004;13:1730–5.

    Article  Google Scholar 

  34. Kadakia SC, Kikendall JW, Maydmovitch C, et al. Effect of cigarette smoking on gastro-oesophageal reflux measured by 24-h ambulatory esophageal pH monitoring. Am J Gastroenterol. 1995;90:1785–90.

    PubMed  CAS  Google Scholar 

  35. Kaufman SE, Kaye MD. Induction of gastro-oesophageal reflux by alcohol. Gut. 1978;19:336–8.

    Article  PubMed  CAS  Google Scholar 

  36. Kitzan J, Wade W, Yu HH. Assessing NSAID prescription use as a predisposing factor for gastro-oesophageal reflux disease in a Medicaid population. Pharm Res. 2001;18:1367–72.

    Article  Google Scholar 

  37. Sontag SJ, Schnell TG, Miller TQ, et al. Prevalence of oesophagitis in asthmatics. Gut. 1992;33:872–6.

    Article  PubMed  CAS  Google Scholar 

  38. Kiligander TO, Laitinen JO. The prevalence of gastro-oesophageal reflux disease in adult asthmatics. Chest. 2004;126:1490–4.

    Article  Google Scholar 

  39. Nishida T, Tsuji S, Tsujii M, et al. Gastroesophageal reflux disease related to diabetes: analysis of 241 cases with type 2 diabetes mellitus. J Gastroenterol Hepatol. 2004;19:258–65.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, 110 029, India

    Praveen Kumar Sharma, Vineet Ahuja, Kaushal Madan, Saurabh Gupta, Akshay Raizada & Mahesh Prakash Sharma

Authors
  1. Praveen Kumar Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vineet Ahuja
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaushal Madan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Saurabh Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akshay Raizada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mahesh Prakash Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vineet Ahuja.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sharma, P.K., Ahuja, V., Madan, K. et al. Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in Northern India. Indian J Gastroenterol 30, 128–134 (2011). https://doi.org/10.1007/s12664-010-0065-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12664-010-0065-5

Keywords

Search

Navigation