Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Dyspeptic and Reflux Symptoms: An Endoscopy-Based Prospective Study from Al Khobar, Saudi Arabia

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BACKGROUND: The prevalence of gastroesophageal reflux disease (GERD) in Saudi Arabia has only been reported using questionnaires, which have low sensitivity and specificity compared with endoscopy. This study aimed to determine the prevalence and associated factors of GERD among dyspeptic adult patients undergoing upper gastrointestinal (GI) endoscopy at a tertiary hospital in Saudi Arabia. PATIENTS AND METHODS: In this prospective observational study, we included all adult patients (aged ≥ 18 years) with persistent dyspeptic and reflux symptoms who were scheduled for upper GI endoscopy at a tertiary academic hospital in Al Khobar, Saudi Arabia, between August 2019 and August 2023. GERD was defined according to the Los Angeles Classification (Grades A-D), while non-erosive reflux disease (NERD) was defined according to the Montreal International Consensus. RESULTS: We included 303 patients in the study (mean age: 44.1 years; female: 57.8%). Endoscopic findings revealed hiatal hernia (51.9%) and esophagitis (31.4%) as the most common esophageal abnormalities, while gastritis (83.5%) and duodenitis (73.7%) were the most common findings in the stomach and duodenum, respectively. The prevalence of GERD was 20.1%, while NERD was the most frequent diagnosis (28.1%). The prevalence of GERD was significantly higher in males (P < 0.001) and among patients with regurgitation (P = 0.033), abnormal esophageal findings (P < 0.001), esophagitis or incompetent cardia (P < 0.001), and gastric ulcers (P = 0.041). Independent predictors of GERD were male gender (OR: 2.77; 95% CI: 1.53-5.01; P = 0.001) and the presence of "other" comorbidities (OR: 2.55; 95% CI: 1.11-5.83; P = 0.027). CONCLUSION: This prospective study found that about one-fifth of the patients undergoing upper GI endoscopy for dyspeptic and reflux symptoms at a tertiary hospital in Al Khobar, Saudi Arabia, had GERD, and more than one-fourth had NERD.

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