title: High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: a Kalixanda study report.
abstract: 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.
authors.affiliation: Centre for Family Medicine, Karolinska Institutet, Stockholm, Sweden. jukka.ronkainen@fimnet.fi
authors.forename: Jukka
authors.initials: J
authors.lastname: Ronkainen
authors.forename: Pertti
authors.initials: P
authors.lastname: Aro
authors.forename: Tom
authors.initials: T
authors.lastname: Storskrubb
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Tore
authors.initials: T
authors.lastname: Lind
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bolling-Sternevald
authors.forename: Hans
authors.initials: H
authors.lastname: Graffner
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
authors.forename: Manfred
authors.initials: M
authors.lastname: Stolte
authors.forename: Lars
authors.initials: L
authors.lastname: Engstrand
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Talley
authors.forename: Lars
authors.initials: L
authors.lastname: Agréus
mesh_terms: 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
chemical_list: D000907:Antibodies, Bacterial