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Gastro-Esophageal Reflux Disease in a Sample of Healthy Iraqi Population Amira H. Shubbar* ,Layth Rafea Taqa** INTRODUCTION: DEFINITION GERD is described as any symptomatic or histopathological alteration resulting from episodes of gastroesophageal reflux, Reflux esophagitis describes the subset of GERD patient with histopathological changes of the esophageal mucosa(1). The clinical diagnosis of GERD is fairly straight forward, if the patient reports a substernal burning sensation radiating upwards the neck, which is promptly relived (albeit transiently) by the ingestion of antacids (2,5). EPIDEMIOLOGY Symptoms consistent with GERD occur in more than one third of the American adults on a monthly basis and weekly in as many as 10%, while 4-10% *Department of Medicine Al-Mustansiriya University. **Ibn AL Bitar for Cardiac Surgery on daily basis (2,3,5,6). Spechler reviewed the epidimiology and natural history of GERD in Orlando and he reported that 20-40% of the adults population experienced heartburn which is the cardinal symptom of GERD, but only some 2% of adults have objective evidence of reflux esophagitis, the incidence of GERD increases with the age, rising dramatically after 40 years of age(7). Also there is a wide geographical variation in prevalence(5,7). While the complications of the GERD (ulcer, stricture and barretts esophagus) are found in up to 20% of patient with esophagitis. The annual mortality of GERD is 1 death per 100 000 patients(8). 33% Healthy Britons had experienced heartburn; 10% had monthly basis symptoms and 3% had daily symptoms (8).In Finland Isolari et. al. estimated the prevalence of symptoms suggestive of GERD in an adult population by questionnaires concerned with the heartburn, regurgitation, ABSTRACT

Abstract

BACKGROUND: Symptoms consistent with GERD occur in more than one third of the American adults on a monthly basis and weekly in as many as 10%, while 4-10% on daily basis OBJECTIVE: To survey the prevalence of symptoms of GERD in a sample of healthy Iraqi population sample. METHOD: Prospective study from Jan 2000- Jun 2000 at the deferent wards of Al-Yarmook teaching hospital, Baghdad. Questionnaires were distributed to 950 healthy persons of different age group attending Al- Yarmouk teaching or visiting their patient at the hospital. The questionnaire included: Taking full history of symptoms suggestive of GERD, including habits and Body Mass Index. RESULTS: Heartburn was experienced by 239 (40.6%) once or more in their life, 30.6% on monthly basis, 11% on weekly basis, 8.3% on daily basis.6.2% of the respondents fulfill the criteria of the European expert panel (EPAGE) criteria for diagnosis of symptomatic GERD. CONCLUSION: Symptomatic GERD is common in our population. Chronic duration of the illness was recognized in one third of them predisposing them to the risk of barrett’s esophagus. Early referral is indicated for better

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