High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: a Kalixanda study report.
OBJECTIVE
Gastroesophageal reflux disease has been reported to be a common burden on health-care resources in the Western world, but its manifestations in the general population are as yet unclear. The aim of this study was to estimate the prevalence of, and to identify the risk factors for gastroesophageal reflux symptoms (GERS) and erosive esophagitis (EE) in the adult population of two Swedish municipalities.


METHODS
A random sample (n =3000) of the adult population (20-81 years of age) of two Swedish municipalities (n =21,610) was surveyed using a validated postal questionnaire assessing gastrointestinal symptoms. The response rate was 74%. A subsample (n = 1000) of the responders was subsequently invited, in random order, for esophago-gastro-duodenoscopy with evaluation of GERS, risk factors and tests for Helicobacter pylori.


RESULTS
GERS were reported by 40.0% and EE was found in 15.5% of the population that had undergone endoscopy. Of those with GERS, 24.5% had EE while 36.8% of those with EE reported no GERS. Hiatus hernia and obesity remained significant risk factors for GERS and/or EE, with or without symptoms in a main effect model (OR up to 14 at EE). Those with active H. pylori infection had a higher risk of GERS without EE than those without H. pylori infection (OR = 1.71 (1.23 2.38)).


CONCLUSIONS
GERS and EE (of which one-third is asymptomatic) are highly prevalent in the Swedish adult population. H. pylori infection seems to play a role in the manifestations of gastroesophageal reflux.
Ronkainen
Jukka
J
Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden. jukka.ronkainen@fimnet.fi
Aro
Pertti
P
Storskrubb
Tom
T
Johansson
Sven-Erik
SE
Lind
Tore
T
Bolling-Sternevald
Elisabeth
E
Graffner
Hans
H
Vieth
Michael
M
Stolte
Manfred
M
Engstrand
Lars
L
Talley
Nicholas J
NJ
Agréus
Lars
L
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D001706:Biopsy; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
D000907:Antibodies, Bacterial