title: Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India.
abstract: BACKGROUND
  The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India.
  
  
  METHODS
  An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs).
  
  
  RESULTS
  The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2).
  
  
  CONCLUSIONS
  GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden.
authors.forename: Hai-Yun
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Population Health and Research Institute, Medical College PO, Trivandrum, Kerala, 695011, India.
authors.forename: Kondarapassery Balakumaran
authors.initials: KB
authors.lastname: Leena
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden.
authors.forename: Amelie
authors.initials: A
authors.lastname: Plymoth
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden.
authors.forename: Maria-Pia
authors.initials: MP
authors.lastname: Hergens
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden.
authors.forename: Li
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Gastroenterology, Sree Gokulam Medical College and Research Foundation, Trivandrum, 695607, India.
authors.forename: Kotacherry Trivikrama
authors.initials: KT
authors.lastname: Shenoy
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden. Weimin.Ye@ki.se.
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001114:Areca; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Gastro-esophageal reflux disease; Prevalence; Questionnaire; Risk factors