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      Gastroesophageal reflux symptoms among Italian university students: epidemiology and dietary correlates using automatically recorded transactions

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          Abstract

          Background

          Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders worldwide, with relevant impact on the quality of life and health care costs.The aim of our study is to assess the prevalence of GERD based on self-reported symptoms among university students in central Italy. The secondary aim is to evaluate lifestyle correlates, particularly eating habits, in GERD students using automatically recorded transactions through cashiers at university canteen.

          Methods

          A web-survey was created and launched through an app, ad-hoc developed for an interactive exchange of information with students, including anthropometric data and lifestyle habits. Moreover, the web-survey allowed users a self-diagnosis of GERD through a simple questionnaire. As regard eating habits, detailed collection of meals consumed, including number and type of dishes, were automatically recorded through cashiers at the university canteen equipped with an automatic registration system.

          Results

          We collected 3012 questionnaires. A total of 792 students (26.2% of the respondents) reported typical GERD symptoms occurring at least weekly. Female sex was more prevalent than male sex. In the set of students with GERD, the percentage of smokers was higher, and our results showed that when BMI tends to higher values the percentage of students with GERD tends to increase. When evaluating correlates with diet, we found, among all users, a lower frequency of legumes choice in GERD students and, among frequent users, a lower frequency of choice of pasta and rice in GERD students.

          Discussion

          The results of our study are in line with the values reported in the literature. Nowadays, GERD is a common problem in our communities, and can potentially lead to serious medical complications; the economic burden involved in the diagnostic and therapeutic management of the disease has a relevant impact on healthcare costs.

          Conclusions

          To our knowledge, this is the first study evaluating the prevalence of typical GERD–related symptoms in a young population of University students in Italy. Considering the young age of enrolled subjects, our prevalence rate, relatively high compared to the usual estimates, could represent a further negative factor for the future economic sustainability of the healthcare system.

          Electronic supplementary material

          The online version of this article (10.1186/s12876-018-0832-9) contains supplementary material, which is available to authorized users.

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          Most cited references35

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          Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease.

          Guidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published in 1995 and updated in 1999. These and other guidelines undergo periodic review. Advances continue to be made in the area of GERD, leading us to review and revise previous guideline statements. GERD is defined as symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus. These guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. Diagnostic guidelines address empiric therapy and the use of endoscopy, ambulatory reflux monitoring, and esophageal manometry in GERD. Treatment guidelines address the role of lifestyle changes, patient directed (OTC) therapy, acid suppression, promotility therapy, maintenance therapy, antireflux surgery, and endoscopic therapy in GERD. Finally, there is a discussion of the rare patient with refractory GERD and a list of areas in need of additional study.
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            Some Effects of "Social Desirability" in Survey Studies

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              Body-mass index and symptoms of gastroesophageal reflux in women.

              Overweight and obese persons are at increased risk for gastroesophageal reflux disease. An association between body-mass index (BMI)--the weight in kilograms divided by the square of the height in meters - and symptoms of gastroesophageal reflux disease in persons of normal weight has not been demonstrated. In 2000, we used a supplemental questionnaire to determine the frequency, severity, and duration of symptoms of gastroesophageal reflux disease among randomly selected participants in the Nurses' Health Study. After categorizing women according to BMI as measured in 1998, we used logistic-regression models to study the association between BMI and symptoms of gastroesophageal reflux disease. Of 10,545 women who completed the questionnaire (response rate, 86 percent), 2310 (22 percent) reported having symptoms at least once a week, and 3419 (55 percent of those who had any symptoms) described their symptoms as moderate in severity. We observed a dose-dependent relationship between increasing BMI and frequent reflux symptoms (multivariate P for trend <0.001). As compared with women who had a BMI of 20.0 to 22.4, the multivariate odds ratios for frequent symptoms were 0.67 (95 percent confidence interval, 0.48 to 0.93) for a BMI of less than 20.0, 1.38 (95 percent confidence interval, 1.13 to 1.67) for a BMI of 22.5 to 24.9, 2.20 (95 percent confidence interval, 1.81 to 2.66) for a BMI of 25.0 to 27.4, 2.43 (95 percent confidence interval, 1.96 to 3.01) for a BMI of 27.5 to 29.9, 2.92 (95 percent confidence interval, 2.35 to 3.62) for a BMI of 30.0 to 34.9, and 2.93 (95 percent confidence interval, 2.24 to 3.85) for a BMI of 35.0 or more. Even in women with a normal baseline BMI, an increase in BMI of more than 3.5, as compared with no weight changes, was associated with an increased risk of frequent symptoms of reflux (odds ratio, 2.80; 95 percent confidence interval, 1.63 to 4.82). BMI is associated with symptoms of gastroesophageal reflux disease in both normal-weight and overweight women. Even moderate weight gain among persons of normal weight may cause or exacerbate symptoms of reflux. Copyright 2006 Massachusetts Medical Society.
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                Author and article information

                Contributors
                martinucci.irene@gmail.com
                michela.natilli@isti.cnr.it
                v.lorenzoni@sssup.it
                lpappalardo@isti.cnr.it
                anna.monreale@di.unipi.it
                g.turchetti@sssup.it
                dino.pedreschi@unipi.it
                santino.marchi@unipi.it
                roberto.barale@unipi.it
                nicola.debortoli@unipi.it
                Journal
                BMC Gastroenterol
                BMC Gastroenterol
                BMC Gastroenterology
                BioMed Central (London )
                1471-230X
                17 July 2018
                17 July 2018
                2018
                : 18
                : 116
                Affiliations
                [1 ]Division of Gastroenterology–Versilia Hospital, Lido di Camaiore–Lucca, Italy
                [2 ]ISNI 0000 0004 1757 3729, GRID grid.5395.a, Department of Computer Science–University of Pisa, ; Pisa, Italy
                [3 ]ISNI 0000 0004 1757 3729, GRID grid.5395.a, Department of Biology–University of Pisa, ; Pisa, Italy
                [4 ]Institute of Management, Scuola Superiore Sant’Anna of Pisa, Pisa, Italy
                [5 ]ISNI 0000 0001 1940 4177, GRID grid.5326.2, Institute of Information Science and Technologies ISTI - Italian National Research Council (CNR), ; Pisa, Italy
                [6 ]ISNI 0000 0004 1757 3729, GRID grid.5395.a, Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery–University of Pisa, ; Pisa, Italy
                Author information
                http://orcid.org/0000-0001-9169-8819
                Article
                832
                10.1186/s12876-018-0832-9
                6050672
                30016938
                2c570356-7e49-4917-9ed9-18caa56bbbc9
                © The Author(s) 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 January 2018
                : 22 June 2018
                Funding
                Funded by: Tuscany region
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Gastroenterology & Hepatology
                gastroesophageal reflux disease,gerd,heartburn,regurgitation,diet,prevalence,university students

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