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Reflux prevalence varies significantly across the world
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The global prevalence of gastroesophageal reflux symptoms varies significantly across different countries, from 2.5% in China to 51.2% in Greece, according to a systematic review and meta-analysis.
Further, Alex Ford, MD, of the Leeds Gastroenterology Institute in the U.K., and colleagues found that older age, smoking status, NSAID use and obesity were modest but significant risk factors for reflux symptoms.
Alex Ford
“This systematic review and meta-analysis has demonstrated that the global prevalence of gastrooesophageal reflux symptoms varies considerably, depending on geographical region, method of data collection, criteria used to define gastrooesophageal reflux and minimum symptom duration required,” Ford and colleagues wrote. “The striking variation in prevalence throughout the world, even when similar definitions are used, or identical questionnaires within different countries, highlights the importance of other factors such as genetic, ethnic and cultural differences on the reporting of upper GI symptoms.”
Ford and colleagues reviewed population-based studies reporting the prevalence of gastroesophageal reflux symptoms published up to September 2016, and included 102 studies in their meta-analysis, which reported on 108 study populations and a total of 460,984 individuals.
The pooled prevalence of gastroesophageal reflux symptoms was 14.8% (95% CI, 13.5-16.1). Prevalence varied significantly between countries, with the lowest reported in China (2.5%) and the highest reported in Greece (51.2%). Based on geographic region, prevalence ranged from 19.6% in Central America to 10% in Asia, which was especially low in Southeast Asia at 7.4%.
Prevalence also varied based on the defining criteria, and when the analysis was restricted to studies that defined gastroesophageal reflux symptoms as a weekly frequency of heartburn or regurgitation, the pooled prevalence was 13.3% (95% CI; 12-14.6). The prevalence was generally higher with Rome I or Rome II criteria.
Finally, Ford and colleagues found that prevalence of symptoms was increased among individuals older than 50 years (OR = 1.32; 95% CI, 1.12-1.54), current smokers (OR = 1.26; 95% CI, 1.04-1.52), NSAID or aspirin users (OR = 1.44; 95% CI, 1.10-1.88) and patients with obesity (OR = 1.73; 95% CI, 1.46-2.06).
“These associations were modest, their overall importance in the etiology of symptoms is questionable and there are likely to be many other factors involved in the pathogenesis of gastro-oesophageal reflux symptoms that we were unable to elucidate via analysis of data from the epidemiological studies we identified,” they concluded. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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