Gastroesophageal reflux disease in a typical African population: a symptom-based multicenter study

Sylvester Chuks Nwokediuko,Dennis Ndububa,Olive Obienu,Abdulfatai Olokoba,Uchenna Ijoma,Sabo Mustapha Umar,Chiedozie Anyanechi,Olusegun Adekanle,Abubakar Maiyaki,Adegboyega Akere,Augustine Uhunmwangho

doi:10.1186/s12876-020-01261-8

Abstract

BackgroundThe prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition. The main objectives of this study were to determine the prevalence and risk factors of GERD, and its degree of overlap with dyspepsia and irritable bowel syndrome (IBS) in Nigeria, a typical African population.MethodsThis was an observational, cross-sectional and descriptive study of adult Nigerians. Diagnosis of GERD was by means of the gastroesophageal reflux disease questionnaire (GERDQ) while the diagnosis of dyspepsia and IBS was based on the Rome III criteria for the diagnosis of functional gastrointestinal disorders. The GERDQ and Rome III questionnaires for dyspepsia and IBS were merged into a composite questionnaire and administered to the study participants who were recruited with a multi-stage sampling technique.ResultsOut of 3520 subjects who participated in the study across the country, 269 (7.6%) satisfied the diagnostic criteria for GERD, while 107 (3.0%) had GERD associated with significant impairment of quality of life. Risk factors of GERD (represented by odds ratios) were age 1.014(95% CI: 1.006–1.022), use of analgesics 1.461 (95% CI: 1.060–2.025), and use of herbs 1.318 (95% CI: 1.020–1.704). Overlap of GERD with dyspepsia and/or IBS was observed in over 50% of cases.ConclusionsThe prevalence of GERD in this study is 7.6%. Age, use of analgesics and use of herbs increase the risk, albeit minimally. A high degree of overlap with dyspepsia and IBS exists in Nigerian patients with GERD.

Highlights

The prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition
A high degree of overlap with dyspepsia and irritable bowel syndrome (IBS) exists in Nigerian patients with GERD
In a more recent study on GERD prevalence and risk factors on a global scale, the prevalence varied according to country from 2.5% in a Chinese to 51.2% in a Greek study [8]

Summary

Introduction

The prevalence of gastroesophageal reflux disease (GERD) in Africa is not known but is believed to be increasing because of demographic and epidemiologic transition. The definition of gastroesophageal reflux disease (GERD) remains work in progress. The Montreal consensus definition is the most widely used, being symptom-based and patient-centered. It defines GERD as symptoms and/or complications resulting from the Nwokediuko et al BMC Gastroenterology (2020) 20:107. Despite these shortcomings, symptom-based approach remains a pragmatic way of defining and diagnosing GERD and is endorsed by societal guidelines [5, 6]. Whereas the validated gastroesophageal reflux disease questionnaire (GERDQ) was used in the Chinese study, the Greek study employed the reflux symptom index [9, 10]. In the Persian gulf and Middle East regions, higher rates have been reported; to 21% in Iran, to 25% in Turkey and 29% in Saudi Arabia [11,12,13,14]

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