Diet, lifestyle and gender in gastro-esophageal reflux disease

Background Studies indicate that gastro-esophageal reflux disease (GERD) is associated with obesity, smoking, esophagitis, diet, and lifestyle. Aim To identify risk factors associated with GERD among patients presenting to a tertiary GI clinic in Italy. Methods Patients with a first diagnosis of GERD based on heartburn and/or regurgitation and/or esophagitis at the endoscopic examination were enrolled. A control group with neither GERD symptoms nor esophagitis was enrolled from the same hospital. Each subject completed a questionnaire including demographic information, lifestyle (e.g., exercise, alcohol, coffee, chocolate, and soda consumption, smoking, having large meals), and frequency of bowel movement. For each participant the body mass index (BMI) was calculated. Results Five hundred subjects were enrolled including 300 GERD patients and 200 controls. Females had significantly higher prevalence of GERD than males (66 vs. 48%, P = 0.001, OR = 2.1, 95% CI = 1.5-3.1). There was an inverse relationship between the level of education and presence of GERD (76% of GERD patients has completed only elementary school (OR = 2.1, 95% CI = 1.7-4.9). Obesity (BMI of >= 95th percentile for their age/gender specific) was significantly related to GERD (OR = 1.8, P = 0.01). None of the other variables studied showed significant associations with GERD. Logistic regression analysis showed that BMI >= 95th percentile, gender, and low education level were significant risk factors for GERD. Conclusions Understanding the epidemiology and risk factors for GERD in a region is the first step in designing prevention and treatment strategies.