Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2017; 23(3): 525-532
Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.525
Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori
Serhat Bor, Gul Kitapcioglu, Elmas Kasap
Serhat Bor, Section of Gastroenterology, Ege Reflux Group, Ege University, Izmir 35040, Turkey
Gul Kitapcioglu, Department of Biostatistics, Ege Reflux Group, Ege University, Izmir 35040, Turkey
Elmas Kasap, Section of Gastroenterology, Celal Bayar University, Manisa 45030, Turkey
Author contributions: Bor S, Kitapcioglu G and Kasap E conceptioned and designed of the study; Generation, collection, assembly, interpretation of data, Drafting or revision of the manuscript, approval of the final version of the manuscript; Kitapcioglu G analysis and/or interpretation of data, approval of the final version of the manuscript; Kasap E Generation, collection, assembly, interpretation of data, approval of the final version of the manuscript.
Supported by This study partially support from Sanovel, Turkey.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Serhat Bor, MD, Section of Gastroenterology, Ege Reflux Group, Ege University, Ege Universitesi Tip Fakultesi, Gastroenteroloji, Bornova, Izmir 35040, Turkey. serhatbor@yahoo.com
Telephone: +90-532-3957677 Fax: +90-232-3731547
Received: August 13, 2016
Peer-review started: August 14, 2016
First decision: September 5, 2016
Revised: October 4, 2016
Accepted: December 2, 2016
Article in press: December 2, 2016
Published online: January 21, 2017
Processing time: 154 Days and 9.8 Hours
Abstract
AIM

To evaluate the prevalence of gastroesophageal reflux disease (GERD) with additional symptoms, relationship with Helicobacter pylori (H. pylori) of this country-wide study.

METHODS

Data from 3214 adults were obtained with validated questionnaire. Eight hundred and forty-one subjects were randomized to be tested for H. pylori via the urea breath test. "Frequent symptoms" were defined heartburn and/or regurgitation occurring at least weekly.

RESULTS

The prevalence of GERD was 22.8%, frequent and occasional heartburn were 9.3%-12.7%, regurgitation were 16.6%-18.7%, respectively. Body mass index (BMI) ≤ 18.5 showed a prevalence of 15%, BMI > 30 was 28.5%. The GERD prevalence was higher in women (26.2%) than men (18.9%) (P < 0001). Overall prevalence of H. pylori was 75.7%. The prevalence was 77.1% in subjects without symptoms vs 71.4% in subjects with GERD (χ2 = 2.6, P = 0.27). Underprivileged with the lowest income people exhibit a higher risk.

CONCLUSION

GERD is common in Turkey which reflects both Western and Eastern lifestyles with high rate of H. pylori. The presence of H. pylori had no effect on either the prevalence or the symptom profile of GERD. Subjects showing classical symptoms occasionally exhibit more additional symptoms compared with those without classical symptoms.

Keywords: Heartburn; Regurgitation; Gastroesophageal reflux disease; Epidemiology; Prevalence

Core tip: Using a validated gastroesophageal reflux disease (GERD) questionnaire and the urea breath test for Helicobacter pylori (H. pylori), we found a relatively high prevalence of GERD and more frequent regurgitation than heartburn. We also determined that the prevalence of GERD increases with increased body mass index and with female gender and decreases with increased education and income, whereas there was no relationship with age, alcohol use, or smoking. Additionally, we found that H. pylori did not affect the prevalence or symptom profile of GERD and that Turkish individual with classical symptoms were more prone to additional symptoms. This unique disease profile may be attributable to Turkey's combination of Western and Eastern lifestyles.