title: Hygiene could affect GERD prevalence independently: a population-based study in Tehran.
abstract: OBJECTIVE
  Population-based data on gastroesophageal reflux disease (GERD) in Iran are limited. Current study is going to determine the prevalence of GERD in Tehran, Iran, and its association with potential risk factors.
  
  
  METHODS
  In this cross-sectional study, a random clustered sample of Tehran province permanent households was selected from the latest postcodes. Data were collected by direct interview for each person aged 18-65 yr. GERD was defined as the existence of at least weekly episodes of heartburn and/or acid regurgitation during the last 6 months. All participants were asked about past and recent sanitary conditions, oral hygiene, and smoking. Odds ratios and 95% confidence intervals (CI) were calculated using multivariable analysis.
  
  
  RESULTS
  Interview was performed with 2,561 eligible subjects (42.3% men). Response rate was 84.8%. The prevalence of GERD was 21.2% (95% CI 18.7-23.7). According to multivariable logistic regression analyses, individuals whose drinking water was obtained from well or tank during childhood were more prone to experience GERD symptoms (OR 1.54, 95% CI 1.03-1.77 and OR 2.46, 95% CI 1.53-3.96, respectively). We also detected significant associations with increasing number of missing teeth (P value for linear trend = 0.02) and history of unpurified water consumption during past 10 yr (P < 0.001). Current smokers had a higher prevalence of reflux (OR 1.82, 95% CI 1.32-2.51).
  
  
  CONCLUSIONS
  The prevalence of GERD in our Iranian population was considerably higher than that reported from other Asian studies approaching western figures. GERD prevalence was significantly associated with the history of unpurified water consumption, poor sanitary conditions of childhood, number of missing teeth, and smoking in this population.
authors: Digestive Disease Research Center, Shariati Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
authors: Mehdi
authors: M
authors: Nouraie
authors: Amir R
authors: AR
authors: Radmard
authors: Hanieh
authors: H
authors: Zaer-Rezaii
authors: Hadi
authors: H
authors: Razjouyan
authors: Siavosh
authors: S
authors: Nasseri-Moghaddam
authors: Reza
authors: R
authors: Malekzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D006920:Hygiene; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014505:Urban Population