Prevalence and risk factors of gastroesophageal reflux disease in a rural Indian population

Background Studies on frequency and risk factors of gastroesophageal reflux disease (GERD) in the rural Indian population are scanty. Methods This household survey was undertaken by the trained interviewers in the adult population (>= 18 years) in four villages in northern India using translated-validated Enhanced Asian Rome III and hospital anxiety and depression questionnaires. Results Of 2774 subjects, 2019 (72.8%) had no heartburn. Heartburn frequency was as follows: 314 (11.3%) once/week, 143 (5.2%) twice/week, 85 (3.1%) thrice/week, 69 (2.5%) four times/week, 48 (1.7%) five times/week, 18 (0.6%) six times/week, 41 (1.5%) daily, 37 (1.4%) > once daily. A total of 298 (10.7%) had GERD (definition: heartburn > twice/week). Older age (36.5 vs. 35 years), non-Hindu religion (7, 2.4% vs. 30, 1.2%), lower education (127, 42.6% vs. 789, 31.9%), lower socioeconomic class (94, 31.5% vs. 517, 20.9%) and income (below Indian National Rupees [INR] 458; 105, 35.2% vs. 599, 24.2%), non-vegetarian diet (15, 5% vs. 105, 4.2%), intake of tea/coffee (260, 87.2% vs. 1687, 68.1%), carbonated soft drinks (216, 72.5% vs. 1234, 49.8%), and alcohol (48, 16.1% vs. 313, 12.6%), tobacco chewing (116, 38.9% vs. 681, 27.5%), and smoking (105, 35.2% vs. 672, 27.1%) were associated with GERD on univariate analysis. On multivariate analysis, body mass index > 25 kg/m(2) (odds ratio [OR] 1.23; 95% CI 0.88-1.71), predominant rice eating (1.13; 0.74-1.74), tobacco chewing and smoking (1.68; 1.24-2.30 and 1.36; 0.99-1.88), and alcohol (1.2; 0.78-1.83) and carbonated soft drinks (2.48; 1.79-3.44) intake were associated with GERD. A total of 122 (41%) had associated functional dyspepsia. Psychological comorbidities were commoner among those with than without GERD. Conclusion In this rural Indian population, 10.7% had GERD and predominant rice eating, tobacco chewing, and carbonated soft drink intake were the risk factors. Psychological comorbidities were common.