Determinants of Gastro-esophageal Reflux Disease in Nablus

Discussion Committee: 
Dr. Hamzeh Al Zabadi /Supervisor
Dr. Yasser Abu Safieh / External Examiner
Dr. Abdulsalam Khayyat / Internal Examiner
Dr. Hamzeh Al Zabadi /Supervisor
Marah Abdel Gaffar Abusalha
Background Gastro-esophageal reflux disease (GERD) is used to describe the symptoms and changes of the esophageal mucosa, that result from reflux of the stomach contents into the esophagus, which is affected by various lifestyle factors, such as age, gender, body mass index (BMI), obesity and other life style factors. GERD is a very common disorder worldwide and it is a very common disease affecting millions of people around the globe. Yet, it has never been investigated in the Palestinian population. We aim to evaluate the potential determinants of GERD severity and frequency of symptoms among the Palestinian population in Nablus district. Materials and methods A cross sectional study using a previously validated questionnaire was performed using face-to-face or telephone call interviews. A non-random purposive sampling technique was used of nearly 120 subjects from the external clinics of An-Najah educational Hospital, Specialized Arab Hospital, Al watani Governmental hospital, and from a private clinic in Nablus. All analysis was conducted using SPSS 16 software. Chi square was used to analyze differences between dependent variable and independent variables. Multivariate logistic regression was also performed in order to adjust for possible confounders. P-value of less than 0.05 was considered statistically significant. Results We were able to recruit 120 participants from three hospitals and one private clinic in Nablus city. The male participants were 40 subjects (33.3% of the sample) while female were 80 (66.7%). Data analysis showed that the majority of participants were more than 50 years old (34.2%). There were no statistically significant differences between the participants and GERD severity regarding age and marital status (P values > 0.05). Furthermore, the most significant variable of the demographic factors were: family members and patients height, and of the exposure factors were: fatty food, coffee consumption and having antihypertensive drugs or NSAID medication. In multivariate logistic regression only those who reported that they usually don’t feel of chest pain during GERD symptoms were less likely to have severe GERD symptoms (OR:0.09; 95% CI: 0.02‐0.52), and those who complained that they always did not have sleeping disturbances due to GERD episodes were also less likely to have sever GERD symptoms (OR:0.05; 95% CI:0.007-0.40). Conclusion Patients showed an increase in the occurrence of GERD symptoms after they exposed to fatty food, coffee consumption and some medication. Increasing public awareness, educating population about; bad life style, wrong eating habits which related to GERD symptoms, and instructing the public about GERD preventive practices, these procedures and others should form an essential basic of the intervention steps. Finally, we recommend further future studies in all internal departments of the Palestinian hospitals, in order to correlate the reported symptoms with the exposed factors and determinants more appropriately.
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