Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi'an of Northwest China.
OBJECTIVE
Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi'an, a northwestern city of China, and to explore the potential risk factors of GERD.


METHODS
Symptoms suggestive of GERD, functional dyspepsia (FD), irritable bowel syndrome (IBS), upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified random samples of 2789 residents aged 18-70 years in Xi'an by using a standardized questionnaire.


METHODS
With a response rate of 91.8%, the prevalence of SGER was 16.98% (95% CI, 14.2-18.92) in Xi'an adults, and no gender-related difference was observed (P<0.05). SGER was more common among subjects aged 30-70 years than in those aged 18-29 years (P<0.01). The prevalence of SGER in rural, urban and suburban subjects was 21.07%, 17.44% and 12.12%, respectively, and there was a significant difference between rural, urban and suburban regions (P<0.05). Compared with subjects without SGER, the prevalence of symptoms suggestive of FD and IBS, pneumonia, asthma, bronchitis, laryngitis, pharyngitis, chronic cough, wheeze, globus sensation, oral ulcer and snore was significantly increased in subjects with SGER (P<0.01). Heavy smoking (OR=5.76; CI, 3.70-6.67), heavy alcohol use (OR=2.85; CI, 1.67-4.49), peptic ulcer (OR=5.76; CI, 3.99-8.32), cerebral palsy (OR=3.97; CI, 1.97-8.00), abdominal operation (OR=2.69; CI, 1.75-4.13), obesity (OR=2.16; CI, 1.47-3.16), excessive food intake (OR=1.43; CI, 1.17-1.15), sweet food (OR=1.23; CI, 0.89-1.54), and consumption of coffee (OR=1.23; CI, 0.17-2.00) were independently associated with SGER. The episodes of GERD were commonly precipitated by dietary factors (66.05%), followed by body posture (26.54%), ill temper (23.72%), fatigue (22.32%) and stress (10.93%).


CONCLUSIONS
GERD is common in Xi'an's adult population with a mild or moderate degree. The etiology and pathogenesis of GERD are probably associated with FD, IBS, and some respiratory, laryngopharyngeal and odontostological diseases or symptoms. Some lifestyles, diseases and dietary factors are the risk factors of GERD.
Wang
Jin-Hai
JH
Department of Gastroenterology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China. jinhaiwang@hotmail.com
Luo
Jin-Yan
JY
Dong
Lei
L
Gong
Jun
J
Tong
Ming
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007827:Laryngitis / Q000453:epidemiology; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data