Iranian lifestyle factors affecting reflux disease among healthy people in Qom

Authors

  • Somayeh Momenyan PhD Candidate in Biostatistics, Paramedical Sciences Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and aim: Gastroesophageal reflux disease (GERD) is one of the most common digestive system disorders. Life style factors may increase the risk of reflux disease. We aimed to determine prevalence of reflux and related life style-factors in the population living in Qom.  Methods: This cross-sectional study was conducted among 1500 residents of Qom in 2014. Individuals were selected through multi-stage sampling. They completed two questionnaires: FSSG questionnaire for diagnosis of GERD and a general questionnaire to measure demographic and lifestyle factors. Univariate and multivariate were used for analysis of data. Data were analyzed using IBM SPSS version 20. Results: A total of 1130 individuals were analyzed in which 52.4% of them were female. Prevalence of GERD was 28%.Adjusted findings showed use of PPIs (OR: 2.2, 95% CI: 2-5), taking H2RAs (OR: 4.7, 95% CI: 2.3-9.4), the habit of quick eating (OR: 1.5, 95% CI: 1.1-2), extra salt consumption on daily meals (OR: 1.5, 95% CI: 1.05-2), lack of sleep (OR: 2.6, 95% CI: 1.5-4.8), and consumption of white bread (OR: 1.7, 95% CI: 1.05-2.7) were related to increased risk of GERD. Conclusion: Our findings showed lifestyle factors such as habit of quick eating, extra salt on regular meals, lack of sleep and use of white bread were associate with increased risk of GERD. However, habit of midnight snack, having dinner just before bedtime, lack of breakfast, smoking, drinking tea and coffee were not associated with increased risk of GERD. It is recommended to carry out a cohort study among the Iranian population to evaluate the effect of life-style risk factors on GERD.

References

Ronkainen J, Agréus L. Epidemiology of reflux symptoms and GORD. Best Pract Res Clin Gastroenterol.

; 27(3): 325-37. doi: 10.1016/j.bpg.2013.06.008. PMID: 23998972.

Yamamichi N, Mochizuki S, Asada-Hirayama I, Mikami-Matsuda R, Shimamoto T, Konno-Shimizu M, et

al. Lifestyle factors affecting gastroesophageal reflux disease symptoms: a cross-sectional study of healthy

adults using FSSG scores. BMC medicine. 2012; 10(1): 1. doi: 10.1186/1741-7015-10-45. PMID:

, PMCID: PMC3353848.

Song JH, Chung SJ, Lee JH, Kim YH, Chang DK, Son HJ, et al. Relationship between gastroesophageal

reflux symptoms and dietary factors in Korea. J Neurogastroenterol Motil. 2011; 17(1): 54-60. doi:

5056/jnm.2011.17.1.54. PMID: 21369492, PMCID: PMC3042219.

Wang HY, Leena KB, Plymoth A, Hergens MP, Yin L, Shenoy KT, et al. Prevalence of gastro-esophageal

reflux disease and its risk factors in a community-based population in southern India. BMC Gastroenterol.

; 16(1): 36. doi: 10.1186/s12876-016-0452-1. PMID: 26979399, PMCID: PMC4791779.

Khoshbaten M. Gastro-esophageal reflux disease in northwestern Tabriz, Iran. Indian J Gastroenterol.

; 22(4): 138-9. PMID: 12962436.

Nasseri-Moghaddam S, Mofid A, Ghotbi MH, Razjouyan H, Nouraie M, Ramard AR, et al.

Epidemiological study of gastro‐oesophageal reflux disease: reflux in spouse as a risk factor. Aliment

Pharmacol Ther. 2008; 28(1): 144-53. doi: 10.1111/j.1365-2036.2008.03708.x. PMID: 18410559.

Esmaillzadeh A, Keshteli AH, Feizi A, Zaribaf F, Feinle-Bisset C, Adibi P. Patterns of diet‐related

practices and prevalence of gastro‐esophageal reflux disease. Neurogastroenterol Motil. 2013; 25(10):

-e638. doi: 10.1111/nmo.12192. PMID: 23895231.

Minatsuki C, Yamamichi N, Shimamoto T, Kakimoto H, Takahashi Y, Fujishiro M, et al. Background

factors of reflux esophagitis and non-erosive reflux disease: a cross-sectional study of 10,837 subjects in

Japan. PLoS One. 2013; 8(7): e69891. doi: 10.1371/journal.pone.0069891. PMID: 23922844, PMCID:

PMC3724738.

Çela L, Kraja B, Hoti K, Toçi E, Muja H, Roshi E, et al. Lifestyle characteristics and gastroesophageal

reflux disease: a population-based study in Albania. Gastroenterology research and practice. 2013; 2013.

doi: 10.1155/2013/936792.

Danjo A, Yamaguchi K, Fujimoto K, Saitoh T, Inamori M, Ando T, et al. Comparison of endoscopic

findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in

Japanese centres. J Gastroenterol Hepatol. 2009; 24(4): 633-8. doi: 10.1111/j.1440-1746.2008.05747.x.

PMID: 19220681.

Nonaka T, Kessoku T, Ogawa Y, Yanagisawa S, Shiba T, Sakaguchi T, et al. Comparative study of 2

different questionnaires in Japanese patients: the quality of life and utility evaluation survey technology

questionnaire (QUEST) versus the frequency scale for the symptoms of gastroesophageal reflux disease

questionnaire (FSSG). J Neurogastroenterol Motil. 2013; 19(1): 54-60. doi: 10.5056/jnm.2013.19.1.54.

PMID: 23350048, PMCID: PMC3548128.

Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K, et al. Development and

evaluation of FSSG: frequency scale for the symptoms of GERD. J Gastroenterol. 2004; 39(9): 888-91. doi:

1007/s00535-004-1417-7. PMID: 15565409.

Aletaha N, Akram P, Norae S, Shahakbar F, Falakzade R. In the city of Gonbad-e Qabus gastroesophageal

reflux disease: prevalence and risk factors. Journal of Medical Council of Islamic Republic of Iran. 2009;

(2).

Spantideas N, Drosou E, Bougea A, Assimakopoulos D. Gastroesophageal reflux disease symptoms in the

Greek general population: prevalence and risk factors. Clin Exp Gastroenterol. 2016; 9: 143-9. doi:

2147/CEG.S103485. PMID: 27382324, PMCID: PMC4922744.

Bor S, Lazebnik LB, Kitapcioglu G, Manannikof I, Vasiliev Y. Prevalence of gastroesophageal reflux

disease in Moscow. Dis Esophagus. 2016; 29(2): 159-65. doi: 10.1111/dote.12310. PMID: 25604401.

Haque M, Wyeth JW, Stace NH, Talley NJ, Green R. Prevalence, severity and associated features of

gastro-oesophageal reflux and dyspepsia: a population-based study. N Z Med J. 2000; 113(1110): 178-81.

PMID: 10917077.

Kennedy T, Jones R. The prevalence of gastro‐oesophageal reflux symptoms in a UK population and the

consultation behaviour of patients with these symptoms. Aliment Pharmacol Ther. 2000; 14(12): 1589-94.

doi: 10.1046/j.1365-2036.2000.00884.x. PMID: 11121906.

Bolin TD, Korman MG, Hansky J, Stanton R. Heartburn: community perceptions. J Gastroenterol Hepatol.

; 15(1): 35-9. doi: 10.1046/j.1440-1746.2000.02051.x. PMID: 10719745.

Stanghellini V. Three-month prevalence rates of gastrointestinal symptoms and the influence of

demographic factors: results from the Domestic/International Gastroenterology Surveillance Study

(DIGEST). Scand J Gastroenterol Suppl. 1999; 231: 20-8. doi: 10.1080/003655299750025237. PMID:

Farup C, Kleinman L, Sloan S, Ganoczy D, Chee E, Lee C, et al. The impact of nocturnal symptoms

associated with gastroesophageal reflux disease on health-related quality of life. Arch Intern Med. 2001;

(1): 45-52. doi: 10.1001/archinte.161.1.45. PMID: 11146697.

Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of

gastroesophageal reflux: a population-based study in Olmsted County, Minnesota. Gastroenterology. 1997;

(5): 1448-56. doi: 10.1016/S0016-5085(97)70025-8. PMID: 9136821.

Kraja B, Burazeri G, Prifti S. Anthropometric indices and gastro-esophageal reflux disease in adult

population in Tirana, Albania. Med Arh. 2008; 62(3): 139-41. PMID: 18822939.

Nocon M, Labenz J, Willich SN. Lifestyle factors and symptoms of gastro‐oesophageal reflux–a

population ‐ based study. Aliment Pharmacol Ther. 2006; 23(1): 169-74. doi: 10.1111/j.1365- 2036.2006.02727.x. PMID: 16393294.

Festi D, Scaioli E, Baldi F, Vestito A, Pasqui F, Di Biase AR, et al. Body weight, lifestyle, dietary habits

and gastroesophageal reflux disease. World J Gastroenterol. 2009; 15(14): 1690-701. doi:

3748/wjg.15.1690. PMID: 19360912, PMCID: PMC2668774.

Fujimoto K. Review article: prevalence and epidemiology of gastro‐oesophageal reflux disease in Japan.

Aliment Pharmacol Ther. 2004; 20 Suppl 8: 5-8. doi: 10.1111/j.1365-2036.2004.02220.x. PMID:

Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux

disease and its complications. Ann Intern Med. 2005; 143(3): 199-211. doi: 10.7326/0003-4819-143-3- 200508020-00006. PMID: 16061918.

Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of

gastro-oesophageal reflux. Gut. 2004; 53(12): 1730-5. doi: 10.1136/gut.2004.043265. PMID: 15542505,

PMCID: PMC1774312.

Matsuki N, Fujita T, Watanabe N, Sugahara A, Watanabe A, Ishida T, et al. Lifestyle factors associated

with gastroesophageal reflux disease in the Japanese population. J Gastroenterol. 2013; 48(3): 340-9. doi:

1007/s00535-012-0649-1. PMID: 22911169.

El-Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a

cross sectional study in volunteers. Gut. 2005; 54(1): 11-7. doi: 10.1136/gut.2004.040337. PMID:

, PMCID: PMC1774352.

Robertson LA, Evans CJ, Lee AJ, Allan PL, Ruckley CV, Fowkes FG. Incidence and risk factors for

venous reflux in the general population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014; 48(2):

-14. doi: 10.1016/j.ejvs.2014.05.017. PMID: 24951373.

Djärv T, Wikman A, Nordenstedt H, Johar A, Lagergren J, Lagergren P. Physical activity, obesity and

gastroesophageal reflux disease in the general population. World J Gastroenterol. 2012; 18(28): 3710-4.

doi: 10.3748/wjg.v18.i28.3710. PMID: 22851863, PMCID: PMC3406423.

Mohammed I, Nightingale P, Trudgill NJ. Risk factors for gastro‐oesophageal reflux disease symptoms: a

community study. Aliment Pharmacol Ther. 2005; 21(7): 821-7. doi: 10.1111/j.1365-2036.2005.02426.x.

PMID: 15801917.

Nandurkar S, Locke GR 3rd, Fett S, Zinsmeister AR, Cameron AJ, Talley NJ. Relationship between body

mass index, diet, exercise and gastro‐oesophageal reflux symptoms in a community. Aliment Pharmacol

Ther. 2004; 20(5): 497-505. doi: 10.1111/j.1365-2036.2004.02156.x. PMID: 15339321.

Published

2021-12-24

Issue

Section

Articles