Epidemiology of Gastroesophageal Reflux Symptoms in Tehran, Iran: A Population-Based Telephone Survey

Background: The prevalence of gastroesophageal reflux disease (GERD) in Asian populations is reported to be lower than that in the West. Population-based data on the prevalence and symptom profile of GERD in developing Caucasian countries is lacking. Our objective was to determine the prevalence of gastrointestinal symptoms and clinical spectrum of GERD in Tehran, northern Iran and their association with patient characteristics. Methods: One thousand seven hundred telephone numbers were randomly selected from Tehran telephone directory using a simple random method. A two-step screening telephone survey was then performed. In each answered call a second rapid survey was done to select a subject 18 – 65 years old from that household. A validated questionnaire was then filled out for that individual. Patient characteristics (age, education, and gender) and history of acid regurgitation and heartburn during the last week, as well as the previous three months were inquired about. Results: Of the 1,700 selected numbers, 278 either did not answer or did not have an eligible case; 220 refused to participate. A total of 1,202 subjects (42% males, mean age: 36 years, range: 18 – 65 yr) were surveyed. The prevalence of heartburn occurring monthly, weekly, and daily was 4.7% (CI95%: 3.5 – 6.0%), 1.6% (CI95%: 1.0 – 2.5%), and 0.6% (CI95%: 0.3 – 1.3%), respectively. The corresponding figures for acid regurgitation were 15.6% (CI95%: 13.6 – 17.7%), 5.7% (CI95%: 4.4 – 7.1%) and 1.5% (CI95%: 0.9 – 2.4%), respectively. The prevalence of GERD, defined as heartburn and/or acid regurgitation experienced daily, weekly and monthly was 1.9% (CI95%: 1.2 – 2.9%), 6.8% (CI95%: 5.4 – 8.3%), and 18.4% (CI95%: 16.2 – 20.6%). There was no relationship between the prevalence of GERD and either gender, age, or education. Conclusion: Monthly GERD symptoms occur in 18.4% of the general population in Tehran. Acid regurgitation is more common (4 – 5 times) than heartburn. Gender, age, and level of education do not affect the prevalence of GERD symptoms in the community studied.