Young Adults' Mental Health Status: Investigating GERD's Relationship with Anxiety and Depression

Systematic Review on Epidemiology of Gastroesophageal Reflux Disease in Asia

The pathogenetic relationship underlying the high prevalence of gastroesophageal reflux disease (GERD) in patients with obstructive sleep apnea (OSA) remains unclear. Objective: 1.To investigate the GER in patients with severe OSA and to corroborate variations in the pH-metry register using auto-CPAP. 2.To test symptoms of GERD at baseline and after beginning treatment for OSA. METHOD: Prospective study with 22 severe OSA patients to study GERD by endoscopic placement of a record of continuous wireless pH monitoring(BravoTM capsule, up to 96 hours recording). After placing the capsule, nocturnal polysomnography study was done and then the auto-CPAP treatment began. Symptoms of GERD were assessed using specific questionnaires (GSRS and QOLARD),filled prior to placement of the capsule, at 96 hours and at a month. RESULTS: 77.2 % were man and obese (63.6%). The incidence of GERD was 65%. After starting auto-CPAP, we observed a significant improvement of parameters associated with the GER in 48 hours, with normalization of pH monitoring in 61.5 % of cases, although without reaching statistical significance. Significant symptomatic changes in the score of the questionnaires at baseline, at 96 hours and at a month after initiation of treatment with auto-CPAP were found. There were with a baseline score for GSRS>2.5 in 40.9% of cases and with the QOLARD CONCLUSIONS: We found a high prevalence of symptomatic GERD in patients with severe OSA. There are significant improvement in symptoms of GERD and tendency to normalization of pathological GER after initiation of treatment with CPAP. These findings could justify the active pursuit of GERD in patients with severe OSA.

A considerable majority of people have gastroesophageal reflux disease (GERD), a common gastrointestinal ailment. Globally, the prevalence of GERD has been rising, and it is linked to several risk factors. In this study, the incidence of GERD in a sample of the population was examined, along with the associated factors that may have an impact on it. The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) was included in a self-administered survey given to 490 participants in a cross-sectional study to help determine who was more likely to have GERD. The questionnaire collected data on demographic elements, health-related traits, and past GERD diagnoses. The findings revealed that 32.7% of the individuals had previously received a GERD diagnosis. Of the patients,17.1% had a GERD-Q score of 8 or above, which indicates a higher likelihood of having GERD. Participants who had previously been diagnosed with GERD had a noticeably greater incidence of GERD, and females had a higher incidence of GERD than males. The frequency of caffeine consumption was substantially correlated with the occurrence of GERD. Our study emphasizes the value of early GERD diagnosis and therapy to reduce problems and enhance the quality of life for those who are affected. According to our research, coffee use, gender, and prior GERD diagnoses are all linked to an increased risk of developing GERD. The GERD-Q is a trustworthy and proven tool for GERD diagnosis and might be used in clinical practice to recognize GERD patients and offer suitable treatment. Additional research is required to determine how additional risk variables affect the prevalence of GERD.

Gastro-oesophageal reflux disease (GERD) is thought to become more prevalent with age. To assess systematically how age affects the prevalence of GERD and its oesophageal complications. Systematic PubMed searches were used to identify population-based studies on the age-related prevalence and incidence of GERD, and clinical studies on age-related changes in oesophageal complications in GERD. Nine population-based studies and seven clinical studies met the inclusion criteria. Four of seven prevalence studies observed no significant effect of age on GERD symptom prevalence, two did not report on statistical significance and one observed a significant age-related increase in symptom prevalence. The two population-based endoscopic surveys showed no significant effect of age on reflux oesophagitis prevalence. Clinical studies in patients with GERD showed an increase in reflux oesophagitis severity and a decrease in heartburn severity with age, and age-related increases in oesophageal acid exposure and anatomical disruption of the gastro-oesophageal junction. Epidemiological studies do not show an increase in GERD symptom prevalence with age. However, in individuals with GERD, ageing is associated with more severe patterns of acid reflux and reflux oesophagitis; despite this, symptoms associated with GERD become less severe and more nonspecific with ageing. Thus, the real prevalence of GERD may well increase with age.

Background Gastroesophageal reflux disease (GERD) is a global gastrointestinal disorder, and obesity is a particular risk factor. Symptoms of GERD, such as heartburn and acid reflux, are caused by abnormal relaxation in the lower esophagus, causing gastric acid reflux. Persistent symptoms can affect the patient's quality of life (QOL) and can cause complications, such as esophageal adenocarcinoma. Management of GERD includes lifestyle changes, antacids, and anti-reflux surgery. Even though GERD is a common disease, few research has been carried out on it in Saudi Arabia. Aim This study aimed to estimate the prevalence of GERD and its associated risk factors among obese individuals in the Al-Baha region population and the effect of GERD on their QOL. Methods A cross-sectional study included 314 obese participants from the Al-Baha region. A questionnaire was filled out to measure the prevalence of GERD, risk factors, and effects on the QOL of the participants. Data were analyzed by the IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). Descriptive statistics and the chi-squared test were applied. Logistic regression analysis was used to determine the factors associated with the incidence of GERD. A p-value of <0.05 was considered statistically significant. Results A total of 314 patients who met our inclusion criteria completed the survey; 42% of them were women, the mean age of all patients was 35.3 ± 12.9 years, and 38.2% of the patients were diagnosed with GERD. Epigastric pain and burning sensation were the most common symptoms (44.9%). Five out of six domains in the QOL questionnaire showed more effects among GERD participants than non-GERD participants, and the results were statistically significant (p = 0.001). Logistic regression analysis showed that men are 1.8 times more likely than women to be diagnosed with GERD, and smokers have 2.6 times the risk of being diagnosed with GERD than non-smokers. Conclusion The present study showed a high prevalence of GERD among obese patients in the Al-Baha region, negatively affecting their QOL. Major risk factors included gender, smoking, dyslipidemia, and hypertension. Public health programs to raise awareness of these risk factors and lifestyle habits are necessary to improve QOL and prevent complications.

Gastroesophageal reflux disease (GERD) is a prevalent chronic condition affecting a significant portion of the adult population worldwide, including Saudi Arabia. GERD is associated with symptoms like heartburn, regurgitation, chest pain, and dysphagia, which can impair the quality of life and increase healthcare burden. Several risk factors, including obesity, dietary habits, and lifestyle choices, contribute to its development. In Saudi Arabia, rapid urbanization and changes in dietary patterns have led to an increasing prevalence of GERD, though research on its association with lifestyle factors is limited. This study aims to assess the prevalence of GERD symptoms in Saudi adults and explore the role of lifestyle factors in its onset and progression. This cross-sectional study was conducted among adults in Saudi Arabia between January and March 2025. The participants completed a self-administered questionnaire that assessed demographic information, GERD symptoms, and lifestyle habits. GERD symptoms were measured using the Gastroesophageal Reflux Disease Questionnaire (GERD-Q). Lifestyle factors, including diet, physical activity, smoking, alcohol consumption, and caffeine intake, were also assessed. Statistical analysis included chi-square tests, t-tests, and multivariable logistic regression to examine associations between GERD symptoms and lifestyle factors. Among the 960 participants, 56.8% (n = 537) reported heartburn, 50.7% (n = 487) regurgitation, 61.1% (n = 587) bloating, 42.5% (n = 411) dysphagia, and 39.3% (n = 380) chest pain. Consumption of spicy food ≥5 times/week was associated with GERD symptoms in 61.2% (n = 161; p = 0.0001), fatty foods in 55.4% (n = 166; p = 0.0005), caffeine in 61.8% (n = 97; p = 0.0001), and alcohol in 59.2% (n = 174; p = 0.0008). Smoking (58.9%, n = 66; p = 0.002) and shisha use (59.2%, n = 174; p = 0.0003) were also significantly associated. Regular physical activity (≥3 times/week) was inversely associated (46.1%, n = 160; p = 0.0001). Higher prevalence was observed in older adults (65+ years: 66.2%, n = 90; p = 0.0002) and those with lower education. This study highlights the significant burden of GERD in Saudi Arabia and emphasizes the role of modifiable lifestyle factors in its onset and progression. Dietary habits, tobacco use, and physical inactivity are major contributors to GERD symptoms. Public health interventions focused on promoting healthier lifestyles, including dietary modifications, increased physical activity, and smoking cessation, could help reduce the prevalence and impact of GERD.

The skinny on obesity and reflux

PROBIOTICS—THE CONCEPTHistory and DefinitionsA century ago, Elie Metchnikoff (a Russian scientist, Nobel laureate, and professor at the Pasteur Institute in Paris) postulated that lactic acid bacteria (LAB) offered health benefits capable of promoting longevity. He suggested that “intestinal autoint

Atypical Symptoms Are Related to Typical Symptoms Rather Than Histologic and Endoscopic Esophagitis

Gastroesophageal reflux disease (GERD) is one of the problems in gastroenterology which causes major disturbance in the quality of life and daily activity. GERD can be divided into erosive and non-erosive type. GERD develops by many factors i.e. anatomical and physiological disorder, hereditary or acquired factors, genetic, diet, certain drugs, and obesity. The principle pathophysiology of GERD is an imbalance between aggressive factors and defensive factors. The aggressive factors include gastric acid, pepsin, bile acid reflux, and trypsin. The defensive factors include hypotensive lower esophageal sphincter (LES), transient lower esophageal sphincter relaxations (TLESR), hiatal hernia, disrupted saliva production, esophageal peristaltic disorder. The complications of GERD divided into esophageal and extra esophageal complications. The complications in the esophagus which can be found are bleeding, stricture, perforation, Barret’s esophagus and esophageal cancer. The complications in the extra esophagus are sore throat, tonsillo-pharyngitis, sinusitis, laryngitis, dental caries, pneumonia, asthma bronchiale, etc. Studies in Indonesia reveal that GERD is increasing recently. Syam et al. reported that the prevalence of GERD in Cipto Mangunkusumo hospital was increasing from 5.7% in 1997 to 25.18% in 2002. From the extrapolated statistic, the prevalence of GERD in Indonesia can be predicted as 7,153,588 patients from 238,452,952 populations. In this edition we have two studies on GERD. The first study studied the frequency scale for the symptoms of GERD score for GERD in Koja hospital Jakarta. Ndraha found that the most frequent characteristic of GERD was female patient, age less than 40 years old, normal body mass index (BMI). The frequency scale for the symptoms of GERD (FSSG) revealed the mean of total score was 17.6 ± 6.9. GERD patients have a high mean FSSG score, whereas dysmotility was more dominant than acid reflux. The second study studied obesity as a risk factor of erosive GERD in Cipto Mangunkusumo hospital Jakarta. Sijabat et al. found from their study that the most frequent characteristic of GERD was grade A esophagitis, female patients and mean age 48.61 ± 8.64 years old. There was a correlation between obesity or abdominal obesity and erosive GERD. The prevalence of GERD in Indonesia is increasing and this data is inline with the reports from other countries in ASIA and USA. The management of GERD is performed in keeping with Indonesian and Asia Pacific consensus, life-style modification and administering the acid suppression agents (proton pump inhibitor, H2-receptor antagonist, etc), prokinetic agents.

BackgroundGastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The prevalence of gastroesophageal reflux disease (GERD) in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy) of GERD in patients with T2DM.MethodsThis cross-sectional case-control study enrolled T2DM patients (n=258) and healthy controls (n=184). All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA) classification was used to grade GERD. GERD was defined as LA grade A (or higher) or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups.ResultsThe prevalence of GERD (32.6% vs. 35.9%, P=0.266) and GERD symptoms (58.8% vs. 59.2%, P=0.503) was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control.ConclusionThe prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

Background: Gastroesophageal reflux disease occurs when gastric juice flows into the esophagus. The presence of psychological issues may increase the risk of GERD, such as anxiety and depression. This study aims to determine the association between GERD symptoms and psychological issues. Methods: A cross-sectional study was done using an online questionnaire distributed through social media platforms (Facebook, Twitter, WhatsApp, Snapchat) to all Saudi residents ≥18 years of both genders. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The Frequency Scale for GERD symptoms (FSSG) was used to suggest GERD. GERD was considered present if the total FSSG score was ≥8. In this study, the FSSG score was used to evaluate both acid-reflux symptoms and dyspeptic symptoms. Hospital Anxiety and Depression Scale (HADS) scores for depression items and for anxiety items were obtained by summing up the discrete scores. A regression model calculates odds ratios and their 95% confidence intervals. Results: A total of 882 participants were investigated. Among participants, the mean age was 31.5 ± 14.9 years old. Prevalence of GERD was 78.2%. A total of 88.2% of participants with depression (cases) had GERD with 3.7 folds than others without (OR=3.7; 95% CI: 2.3-5.8). Also, those with borderline depression had 3.5 folds for GERD than normal participants (OR=3.5; 95% CI: 2.3-5.2). As for anxiety, participants with anxiety disorder (cases) had GERD with 5.3 folds than others without (OR=5.3; 95% CI: 3.0-9.4). Also, those with borderline anxiety had 2.7 folds for GERD than normal participants (OR=2.7; 95% CI: 1.7-4.3). Conclusion: Our data revealed a significant positive association between the prevalence of GERD in participants with anxiety and depression compared to those without psychological factors. The correlation between GERD and anxiety is higher than between GERD and depression. We recommend offering an evaluation as early as possible for GERD for all patients with depression and anxiety.

Objective To investigate the symptom, esophageal motility characteristics and the prevalence of gastroesophageal reflux disease (GERD) in patients with type Ⅰ, Ⅱ and Ⅲ gastroesophageal junction (EGJ) diagnosed by high resolution esophageal manometry (HREM). Methods From 6th January to 27th December in 2012, the clinical data of 171 patients with reflux symptoms and received HREM were retrospectively analyzed. According to the Chicago classification V. 3.0, the patients were divided into EGJ type Ⅰ, Ⅱ and Ⅲ groups. The age, body mass index (BMI), GERD related symptoms, esophageal motility parameters and the incidence of GERD were compared among the three groups. Chi-square test, t test and analysis of variance were used for statistical analysis. Relationship between EGJ types and other variables were analyzed by Spearman rank correlation. Results In 171 patients, 136 cases (79.5%) with type Ⅰ EGJ, 22 cases (12.9%) with type Ⅱ EGJ and 13 cases (7.6%) with type Ⅲ EGJ. The age of patients with type Ⅱ EGJ was significantly older than that of patients with type Ⅰ EGJ ((56.5±2.3) years vs (48.6±1.0) years, t=2.992, P=0.003), however the differences were not statisticant when compared with type Ⅲ EGJ patients ((51.2±3.8) years, P>0.05). The BMI of patients with type Ⅲ EGJ was higher than that of type Ⅰ and type Ⅱ EGJ patients ((26.0±1.3) kg/m2 vs (21.9±0.3) kg/m2 and (23.5±0.6) kg/m2), and the difference was statistically significant (t=4.082 and 2.108, both P<0.05). The resting pressure of lower esophageal sphincter (LES) of patients with type Ⅱ and Ⅲ EGJ were lower than that of type Ⅰ EGJ ((10.6±1.5) mmHg (1 mmHg=0.133 kPa) and (3.4±0.7) mmHg vs (17.1±0.7) mmHg), and the resting pressure of LES of type Ⅲ EGJ was lower than that of type Ⅱ EGJ ((3.4±0.7) mmHg vs (10.6±1.5) mmHg), and the differences were all statistically significant (t=-3.882, -6.411 and -2.769, all P<0.01). The amplitude of contraction at 11 cm above LES and distal contractile integral (DCI) of patients with type Ⅲ EGJ were both lower than those of patients with type Ⅰ EGJ ((32.2±5.4) mmHg vs (48.5±2.5) mmHg, and (392.0±94.1) mmHg·s·cm vs (805.1±61.4) mmHg·s·cm), and the differences were statistically significant (t=-2.580 and -2.041, both P<0.05). The incidences of GERD in patients with type Ⅰ, Ⅱ and Ⅲ EGJ were 68.4%(93/136), 77.3%(17/22) and 10/13, respectively, and the difference was not statistically significant (χ2 =1.021, P=0.600). EGJ types were positively correlated with age and BMI (r=0.214 and 0.290, both P<0.01). However, EGJ types were negatively correlated with the LES resting pressure, contraction amplitudes at 7 cm and 11 cm above the LES, and DCI (r=-0.474, -0.182, -0.333 and -0.191, all P<0.05). Conclusions Aging, overweight and obesity are risk factors of the LES and crural diaphragm separation. EGJ types are not predictable based on symptoms. The esophageal motility seems to decrease in patients with type Ⅱ and Ⅲ EGJ, the incidence of GERD in patients with type Ⅰ, Ⅱ and Ⅲ EGJ are all high. Key words: Gastroesophageal reflux; Gastroesophageal junction types; High resolution esophageal manometry

Frequency scale symptoms for gastroesophageal reflux disease (Frequency Scale for Symptoms of GERD) predicts need for addition of prokinetics to proton pump inhibitor therapy

Background. This study was aimed to investigate the prevalence and habit-associated risk factors of gastroesophageal reflux disease (GERD) among fishermen.Methods. A cross-sectional study was conducted among 168 adult fishermen in Cirebon Regency, West Java, Indonesia. A self-administered questionnaire was given. The questionnaire consisted of demographic characteristics and validated GERD questionnaire (GERDQ) in Indonesian language. Data were analyzed using descriptive statistics and chi-square test. The study has been approved by the Medical Research Ethic Comiittee.Results. The medan age of the participants was 39.0 (24-86) years old. They were predominanty (60.7%) female. The prevalence of GERD was 22.6%. According to bivariate analysis, there was association between smoking (PR 1.181; 95%CI 1.013-1.377;p 0.041), high-salt intake (PR 2.419;95%CI 1.079-5.424; p 0.029), herb consumption (PR 3.068; 95%CI 1.307-7.200; p 0.008), poor hand hygiene (PR 3.202; 95%ci 1.445-7.095; p 0.003), and non-steroidal anti-inflammatory drug (NSAID) consumption (PR 3.062; 95%CI 1.446-6.488; p 0.00) with GERD. Tea consumption, coffee consumption, and raw vegetable eating were not associated with GERD.Conclusions This population-based study showed that the prevalence of GERD among fishermen in Indonesia is high. Habits associated with GERD in this study were smoking, high-salt intake, herb consumption poor, hand hygiene,