Purpose: To determine the natural history and risk factors associated with GERD patients presenting in tertiary GI clinics, Italy.
Methods: Patients with a first diagnosis of GERD between 2004 and 2005 were included. The diagnosis of GERD was based on classic symptoms of heartburn and/or acid regurgitation. The cases were classified endoscopically as erosive, non-erosive esophagitis, or Barrett's esophagus. A control group was enrolled from the same hospital without GERD symptoms. A detailed questionnaire collected data regarding demographic information, life style such as exercise, alcohol, coffee, chocolate, and soda consumption, smoking, having abundant meals, and frequency of bowl movement. Height and weigh were recorded and Body Mass Index (BMI) was calculated. Obesity was scored using the gender/age specific body mass index Z-score (standard deviation score) and BMI calculated as Wt (kg)/Ht (cm)/100)2. Obesity was based on a BMI of ≥95th percentile and was age/gender specific.
Results: A total of 500 subjects were enrolled. There were 300 GERD patients between the ages of 12–80, and 200 controls. Females had a significantly higher prevalence of GERD than males (66% vs. 48%, p= 0.001, OR = 2.1, 95% CI = 1.5–3.1). The level of education had an inverse effect on GERD; 76% of those who only completed elementary school had GERD compared to 43% of those completed college (p= 0.001, OR = 2.1, 95% CI = 1.7–4.9). Obese individuals were significantly more likely to have GERD compared to those not obese (66% vs. 56%; respectively; OR = 1.8, p=.01). None of the other studied variables showed significant association with GERD. Logistic regression analysis including all the study variables in the model showed that BMI ≥ 95th percentile, gender and low educational level were significant risk factors for GERD.
Conclusions: GERD is more prevalent among Italian women than men and associated with a high BMI and a low socioeconomic status (as measured by educational level). None of the dietary factors assessed were associated with GERD. Identification of the epidemiology and risk factors allows targeted studies regarding the pathogenesis and current management of GERD.