Prevalence of gastroesophageal reflux disease and its associated factors among professional college students in North Kerala
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20261426Keywords:
Prevalence, Gastro esophageal reflux, Students, SymptomsAbstract
Background: Gastroesophageal reflux disease (GERD) is a condition wherein reflux of gastric contents produces troublesome symptoms and complications, significantly impacting quality of life. The objective is to determine the prevalence of gastroesophageal reflux disease and its associated factors among professional college students in North Kerala. To assess its symptom severity.
Methods: A cross-sectional study was conducted among 320 professional college students aged ≥18 years in North Kerala during a period of one year using stratified multistage random sampling. Data were collected through a semi-structured self-administered questionnaire. GERD was assessed using the validated Frequency Scale for the Symptoms of GERD, with a score >8 considered diagnostic. Data were analysed using SPSS. Appropriate statistical tests were applied; p< 0.05 was considered significant.
Results: The mean age was 20.85 ± 1.83 years with equal gender distribution. The prevalence of GERD was 38% (121), higher among medical students (24.6%) than engineering students (13.4%). Mild, moderate, and severe symptoms were observed in 20.4%, 13.1%, and 4.4% respectively. Significant association were found between GERD and medical stream, hostel stay, co-morbidities, family history, stress, regular medication and analgesic use, unhealthy dietary habits life frequent hotel meals and aerated drinks. Physical activity showed a protective effect.
Conclusions: GERD prevalence was 38% among professional college students, particularly higher among medical students. Lifestyle factors, stress, and certain medical conditions were significantly associated, while physical activity was protective. Promoting healthy diet, regular exercise, and stress management may reduce risk.
References
Nirwan JS, Hasan SS, Babar ZUD, Conway BR, Ghori MU, Dickson RJ, et al. Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis. Sci Rep. 2020;10:5814. DOI: https://doi.org/10.1038/s41598-020-62795-1
Jo SJ, Kim N, Lim JH, Shin CM, Park YS, Lee DH, et al. Comparison of gastroesophageal reflux disease symptoms and proton pump inhibitor response using gastroesophageal reflux disease impact scale questionnaire. J Neurogastroenterol Motil. 2013;19(1):61-9. DOI: https://doi.org/10.5056/jnm.2013.19.1.61
Vakil N, Van Zanten SV, Kahrilas P, Dent J, Jones R. Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900-20. DOI: https://doi.org/10.1111/j.1572-0241.2006.00630.x
Djärv T, Wikman A, Nordenstedt H, Johar A, Lagergren J, Lagergren P. Physical activity, obesity and gastroesophageal reflux disease in the general population. World J Gastroenterol. 2012;18(28):3710-4. DOI: https://doi.org/10.3748/wjg.v18.i28.3710
Sharma A, Sharma PK, Puri P. Prevalence and the risk factors of gastro-esophageal reflux disease in medical students. Med J Armed Forces India. 2018;74(3):250-4.
Rai S, Kulkarni A, Ghoshal UC. Prevalence and risk factors for gastroesophageal reflux disease in the Indian population: A meta-analysis and meta-regression study. Indian J Gastroenterol. 2021;40(2):209-19. DOI: https://doi.org/10.1007/s12664-020-01104-0
Bhatia S, Pareek KK, Kumar A, Upadhyay R, Tiwaskar M, Jain A, et al. API-ISG Consensus Guidelines for Management of Gastrooesophageal Reflux Disease. J Assoc Physicians India. 2020;68(10):69-80.
National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of GER and GERD. Bethesda (MD): NIDDK. 2025. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes. Accessed on 05 February 2026.
GERD pathogenesis, pathophysiology, and clinical manifestations. ResearchGate. 2018. Available at: https://www.researchgate.net/publication/8935169_GERD_pathogenesis_pathophysiology_and_clinical_manifestations. Accessed on 05 February 2026.
Nonaka T, Kessoku T, Ogawa Y, Yanagisawa S, Shiba T, Sakaguchi T, et al. Comparative Study of 2 Different Questionnaires in Japanese Patients: The Quality of Life and Utility Evaluation Survey Technology Questionnaire (QUEST) Versus the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease Questionnaire (FSSG). J Neurogastroenterol Motil. 2013;19(1):54-60. DOI: https://doi.org/10.5056/jnm.2013.19.1.54
Kusano M, Shimoyama Y, Sugimoto S, Yamaguchi K, Hirakawa M, Ohkusa H, et al. Development and evaluation of FSSG: frequency scale for the symptoms of GERD. J Gastroenterol. 2004;39(10):888-91. DOI: https://doi.org/10.1007/s00535-004-1417-7
Karthik RC, Balaji SM, Arumugam B, Sriram RM, Ezhilvanan M. Prevalence of gastro-esophageal reflux disease among medical students in Chennai, South India. Indian J Forensic Community Med. 2017;4(3):199-203.
Ramya Sree M, Kolli H, Periyasamy B, Praveen V. A cross-sectional study to evaluate the prevalence and risk factors of gastro-esophageal reflux disease among the undergraduate medical students of a tertiary-care Indian setting. MGM J Med Sci. 2023;10(2):102-5. DOI: https://doi.org/10.4103/mgmj.mgmj_186_22
Belete M, Tesfaye W, Akalu Y, Assefa D, Abebe Y, Teka Y, et al. Gastroesophageal reflux disease symptoms and associated factors among university students in Amhara region, Ethiopia, 2021: a cross-sectional study. BMC Gastroenterol. 2023;23(1):130. DOI: https://doi.org/10.1186/s12876-023-02758-8
Kariri AM, Darraj MA, Wassly AM, Alzahrani HA, Aljohani SM, Alzahrani FA, et al. Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Southwestern Saudi Arabia. Cureus. 2020;12(1):e6626. DOI: https://doi.org/10.7759/cureus.6626
Bin Abdulrahman KA, Alsaif AF, Almehaidib IA, Almtehe MA, Alqahtani NM, Alabdali AK. Prevalence and risk factors of gastro-esophageal reflux disease among college students at a public university in Riyadh, Saudi Arabia. J Family Med Prim Care. 2024;13(4):1401-7. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1715_23
Alrashed AA, Aljammaz KI, Pathan A, Mandili AA, Almatrafi SA, Almotire MH, et al. Prevalence and risk factors of gastroesophageal reflux disease among Shaqra University students, Saudi Arabia. J Family Med Prim Care. 2019;8(2):462-7. DOI: https://doi.org/10.4103/jfmpc.jfmpc_443_18
Arivan R, Deepanjali S. Prevalence and risk factors of gastro-esophageal reflux disease among undergraduate medical students from a southern Indian medical school: a cross-sectional study. BMC Res Notes. 2018;11(1):448. DOI: https://doi.org/10.1186/s13104-018-3569-1
Gaude GS, Hattiholi J, Bhoma G. Risk of gastroesophageal reflux disease in bronchial asthma: a prospective study using FSSG scale and gastroesophageal endoscopy. Arch Med. 2016;8(3). DOI: https://doi.org/10.14260/jemds/2014/2708
Martinucci I, De Bortoli N, Giacchino M, Savarino E, Dulbecco P, Bertani L, et al. Prevalence of gastro-esophageal reflux disease symptoms in the general population: A cross-sectional study in Italy. BMC Gastroenterol. 2018;18(1):116. DOI: https://doi.org/10.1186/s12876-018-0832-9
Challa N, Goel N, Rohilla R, Rana K. Prevalence and Correlates of Gastroesophageal Reflux Disease (GERD) amongst undergraduate Students in a city of North India. Int J Health System and Implementation Res. 2024;8(1):48-54.
Sharma A, Sharma PK, Puri P. Prevalence and the risk factors of gastro-esophageal reflux disease in medical students. Med J Armed Forces India. 2018;74(3):250-4. DOI: https://doi.org/10.1016/j.mjafi.2017.08.005
Parasher A, Ranjan K. The prevalence of gastroesophageal reflux disease and its association with various risk factors in a tertiary care centre in West Bengal. Int J Res Med Sci. 2021;9(3):780-5. DOI: https://doi.org/10.18203/2320-6012.ijrms20210877
Ruszniewski P, Soufflet C, Barthélémy P. Nonsteroidal anti-inflammatory drug use as a risk factor for gastro-oesophageal reflux disease: an observational study. Aliment Pharmacol Ther. 2008;28(9):1134-9. DOI: https://doi.org/10.1111/j.1365-2036.2008.03821.x
Essa A, Nasser A, Noureldeen IM, Ebeid I, Ebeid A, Ahmed B, et al. Gastroesophageal Reflux Disease Among Undergraduate Medical Students in Egypt: Prevalence and Risk Factors. Int J Gen Med. 2024;17:6037-46. DOI: https://doi.org/10.2147/IJGM.S503049
Khodarahmi M, Azadbakht L, Daghaghzadeh H, Feinle-Bisset C, Keshteli AH, Afshar H, et al. Evaluation of the relationship between major dietary patterns and un investigated reflux among Iranian adults. Nutrition. 2016;32(5):573-83. DOI: https://doi.org/10.1016/j.nut.2015.11.012
Murase K, Tabara Y, Takahashi Y, Muro S, Yamada R, Setoh K, et al. Gastroesophageal reflux disease symptoms and dietary behaviors are significant correlates of short sleep duration in the general population: the Nagahama Study. Sleep. 2014;37(11):1809-15. DOI: https://doi.org/10.5665/sleep.4176
Atta MM, Sayed MH, Zayed MA, Alsulami SA, Al-Maghrabi AT, Kelantan AY. Gastro-oesophageal reflux disease symptoms and associated risk factors among medical students, Saudi Arabia. Int J Gen Med. 2019;12:293-8. DOI: https://doi.org/10.2147/IJGM.S206995
Johnson T, Gerson L, Hershcovici T, Stave C, Fass R. Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2010;31(6):607-14. DOI: https://doi.org/10.1111/j.1365-2036.2010.04232.x
Newberry C, Lynch K. The role of diet in the development and management of gastroesophageal reflux disease: why we feel the burn. J Thorac Dis. 2019;11(12):S1594-601. DOI: https://doi.org/10.21037/jtd.2019.06.42
Hamoui N, Lord RV, Hagen JA, Theisen J, Demeester TR, Crookes PF. Response of the lower esophageal sphincter to gastric distention by carbonated beverages. J Gastrointest Surg. 2006;10:870-7. DOI: https://doi.org/10.1016/j.gassur.2005.11.010
Ginting EB, Darmadi, Sofyan F, Kaban SM. Relationship between Gastroesophageal Reflux Disease (GERD) with Quality of Sleep. J Endocrinol Trop Med Infect Dis (JETROMI). 2024;6(2):62-8. DOI: https://doi.org/10.32734/jetromi.v6i2.14955
Dore MP, Maragkoudakis E, Fraley K, Pedroni A, Tadeu V, Realdi G, et al. Diet, lifestyle and gender in gastro-esophageal reflux disease. Dig Dis Sci. 2008;53(8):2027-32. DOI: https://doi.org/10.1007/s10620-007-0108-7
Goyal O, Nohria S, Dhaliwal AS, Goyal P, Soni RK, Chhina RS, et al. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India. Indian J Gastroenterol. 2021;40(2):144-53. DOI: https://doi.org/10.1007/s12664-020-01106-y
Odah MM, Ewis AA, Alessi AA, Alhasani TM, Alghanmi AA, Almarhabi AA, et al. Prevalence of Gastroesophageal Disease and Associated Risk Factors Among the Population in Al-Qunfudah. Cureus. 2021;13(12):e20325. DOI: https://doi.org/10.7759/cureus.20325
Downloads
Published
How to Cite
Issue
Section
