ANNALS OF IBADAN POSTGRADUATE MEDICINE
A.C. Jemilohun1, B.O. Oyelade2, J.O. Fadare3 and I.O. Amole4
Background: Gastroesophageal reflux disease is a common disorder globally but the prevalence and severity of symptoms and complications do have ethnic and geographic variations.
Aim: The aim of the study was to determine the prevalence of gastroesophageal reflux disease (GERD) among adults in Ogbomoso, Southwest Nigeria, and the risk factors associated with it.
Methodology: The study was a hospital-based descriptive cross-sectional survey. The study population consisted of consenting male and female adults aged 18 to 87 years recruited from the outpatient departments of three health institutions in Ogbomoso, Oyo State, Nigeria. A predesigned questionnaire consisting of GerdQ and other relevant information was administered to the participants.
Results: A total of 772 subjects were interviewed. The prevalence of GERD was 9.3% among the subjects. There was a significant association between increasing age and GERD. Other risk factors considered showed no significant association with the disease.
Conclusion: GERD has a moderate prevalence among adults in Ogbomoso, Southwest Nigeria and there is a significant association between increasing age and GERD.
Keywords: Gastroesophageal reflux disease, Prevalence, Risk factors, Nigeria
Dr. A.C. Jemilohun
LAUTECH Teaching Hospital,
Ogbomoso, Oyo State,
Gastroesophageal reflux disease (GERD) is a condition which develops when reflux of stomach contents into the oesophagus causes troublesome symptoms and/or complications.1 It typically presents as recurrent heartburn and/or regurgitation with or without endoscopic evidence of mucosal injury.1
Gastroesophageal reflux disease is a common disorder globally but the prevalence severity of symptoms and complications do have ethnic and geographic variations.2,3 The prevalence rate in Western adult population ranges from 10-20% while less than 5% are affected in Asia.4 It is generally believed that GERD is more common among the Caucasian population as compared to the Afro-Caribbean populations,3 but recent studies among population subgroups in some parts of Nigeria suggest the contrary.5–7
The aetiology of GERD is multifactorial as both environmental and genetic factors plays different roles. Studies from various populations around the world show that risk factors for GERD include age, excessive body weight, hiatal hernia, lifestyle factors (such as smoking, alcohol intake, physical activity), diet (coffee, alcohol, chocolate and fatty meals), medications (betaagonists, nitrates calcium channel blockers and anticholinergics), hormones (e.g. progesterone).8–12 The etiological effector of GERD is excessive retrograde movement of acid-containing gastric secretion or a combination of acid and bile containing secretions from the stomach and the duodenum into the oesophagus. Frequent (functional) transient lower oesophageal sphincter (LES) relaxation or mechanical (hypotensive LES) problem of the LES which results from different combinations of the identified etiological factors is the main cause of GERD.8–13
Numerous validated patient-centred symptoms analyses-based questionnaires with varying degree of accuracy have been designed for the assessment of GERD.14 Symptoms analyses method of diagnosis is a pragmatic approach to diagnosing GERD since it eliminates the use of costly diagnostic procedures such as upper gastrointestinal endoscopy and 24-hour gastric pH-monitoring are not required in most patients who present with the typical symptoms of GERD.6,15,16
The GerdQ is a simple, patient-centred, self-assessment questionnaire which has a diagnostic accuracy similar to that of the gastroenterologist.17 The questionnaire has been validated and found to be a useful tool to detect unmet therapeutic needs.17–19 The contents of the questionnaire are consistent with the Montreal definition and classification of GERD as articulated in a global evidence-based consensus.1,17
This study therefore aimed at determining the prevalence rate of GERD among adults living in Ogbomoso, Southwest Nigeria, using the GerdQ, and the relationship between previously identified etiological factors and GERD among the study population.