title: Gastroesophageal reflux disease in a low-income region in Turkey.
abstract: OBJECTIVE
  Detailed population-based data regarding the prevalence and symptom profile of gastroesophageal reflux disease (GERD) in underdeveloped and developing Caucasian countries are lacking. The aim of this study was to determine the prevalence and clinical spectrum of GERD in a low-income region in Turkey.
  
  
  METHODS
  We used a previously validated reflux questionnaire, which was translated into Turkish and culturally adapted. The questionnaire was applied to 630 randomly selected participants greater than 20 yr old living in a population of 8,857 adults, with a low mean income of 75 dollars/person/month. The reliability and reproducibility of the questionnaire were calculated using the kappa statistic (test-retest). Endoscopy and/or 24-h intraesophageal pH monitoring were used to ascertain its validity in identifying patients with reflux.
  
  
  RESULTS
  The prevalence of GERD symptoms was 10% for heartburn, 15.6% for regurgitation, and 20% for either symptom experienced at least weekly (95% CI). Heartburn and regurgitation were associated with noncardiac chest pain (37.3%), dysphagia (35.7%), dyspepsia (42.1%), odynophagia (35.7%), globus, hoarseness, cough, hiccup, nausea, vomiting, belching, and NSAID use, but not with body mass index in both frequent and occasional symptom groups. The prevalence of heartburn symptoms, but not regurgitation, increased significantly with age.
  
  
  CONCLUSIONS
  The prevalence of GERD in a low-income population in Turkey was similar to that of developed countries, although with a different symptom profile, namely, a lower incidence of heartburn and a higher incidence of regurgitation and dyspepsia. These findings support the contention that there are a large number of patients worldwide in underdeveloped nations with poorly recognized and largely undertreated GERD.
authors.affiliation: Department of Gastroenterology, Public Health and Anesthesiology, Ege University, Izmir, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Bor
authors.forename: Aliye
authors.initials: A
authors.lastname: Mandiracioglu
authors.forename: Gul
authors.initials: G
authors.lastname: Kitapcioglu
authors.forename: Canan
authors.initials: C
authors.lastname: Caymaz-Bor
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gilbert
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004415:Dyspepsia / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology*; D006306:Health Surveys; D006356:Heartburn / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology