Original Article
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2014; 20(46): 17388-17398
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17388
Epidemiology of upper gastrointestinal symptoms in Brazil (EpiGastro): A population-based study according to sex and age group
Maria do Rosário Dias de Oliveira Latorre, Aline Medeiros da Silva, Décio Chinzon, Jaime N Eisig, Telma RP Dias-Bastos
Maria do Rosário Dias de Oliveira Latorre, Aline Medeiros da Silva, Department of Epidemiology, Faculty of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
Décio Chinzon, Jaime N Eisig, Department of Gastroenterology, Faculty of Medicine, University of São Paulo, São Paulo 05409-001, Brazil
Aline Medeiros da Silva, Telma RP Dias-Bastos, Janssen-Cilag Farmacêutica Ltda., São Paulo 05501-900, Brazil
Author contributions: All authors contributed to study design as well as data acquisition, analysis, and interpretation; Rosário Dias de Oliveira Latorre M drafted the manuscript with assistance from Stephen W Gutkin; all authors revised the manuscript for intellectual content; all authors approved the final manuscript; Rosário Dias de Oliveira Latorre M had access to all data analyzed and takes responsibility for the analysis and this report (study guarantor).
Supported by Janssen-Cilag Farmacêutica Ltda., São Paulo, Brazil
Correspondence to: Maria do Rosário Dias de Oliveira Latorre, PhD, Department of Epidemiology, Faculty of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, São Paulo 01246-904, Brazil. mdrddola@usp.br
Telephone: +55-11-30617935 Fax: +55-11-30617799
Received: March 6, 2014
Revised: July 15, 2014
Accepted: August 13, 2014
Published online: December 14, 2014
Processing time: 287 Days and 6.3 Hours
Abstract

AIM: To determine the prevalences of symptoms consistent with gastroesophageal reflux disease (GERD) and dyspepsia in South America.

METHODS: A telephone survey was conducted among adult owners of land-based telephones in São Paulo, Brazil, using previously validated computer-assisted sampling and survey protocols. The Portuguese-language survey included (1) sociodemographic characteristics (e.g., weight, height, smoking) and comorbidities; (2) dietary habits; (3) presence of symptoms consistent with GERD or dyspepsia within the prior 3 mo; and (4) use of medications and other therapies to manage symptoms. Data were stratified post-hoc into three homogeneous geographical regions of São Paulo according to the Social Exclusion Indices of the districts and postal codes. Survey response data from each respondent were weighted by the numbers of adults and landline telephones in each household. The analyses were weighted to account for sampling design and to be representative of the São Paulo population according to city census data.

RESULTS: Among 4570 households contacted, an adult from 3050 (66.7%) agreed to participate. The nonresponse rate was 33.3%. The mean (SE) respondent age was 42.6 (16.0) years. More than half of all respondents were women (53.1%), aged 18 through 49 years (66.7%), married or cohabitating (52.5%), and/or above normal-weight standards (i.e., 35.3% overweight and 16.3% obese). A total of 26.5% of women were perimenopausal. More than 20% of respondents reported highly frequent symptoms consistent with GERD (e.g., gastric burning sensation = 20.8%) or dyspepsia (e.g., abdominal swelling/distension = 20.9%) at least once per month. Prevalences of these symptoms were significantly (approximately 1.5- to 2.0-fold) higher among women than men but did not vary significantly as a function of advancing age. For instance, 14.1% of women reported that they experienced stomach burning (symptom of GERD) at least twice per week, compared to 8.4% of men (P = 0.012 by χ2 test). A total of 15.7% of women reported that they experienced abdominal swelling (symptom of dyspepsia) at least twice per week, compared to 6.4% of men (P < 0.001 by χ2 test). Despite frequent manifestations of GERD or dyspepsia, most (≥ 90%) respondents reported that they neither received prescription medications from physicians, nor took behavioral measures (e.g., dietary modifications), to manage symptoms.

CONCLUSION: Symptoms consistent with dyspepsia and GERD are prevalent in Brazil and represent major public-health and clinical challenges.

Keywords: Dyspepsia; Epidemiology; Esophagus; Gastroesophageal reflux; Prevalence; Stomach

Core tip: Among residents of São Paulo responding to our survey, approximately 21% reported that they experienced highly frequent symptoms consistent with gastroesophageal reflux disease (GERD) or dyspepsia at least once per month in the prior 3 mo. Prevalences of these symptoms were significantly (about 1.5- to 2.0-fold) higher among women than men but did not vary significantly as a function of advancing age. Despite frequent manifestations of GERD or dyspepsia, most (≥ 90%) respondents reported that they neither received prescription medications from physicians, nor took behavioral measures (e.g., dietary modifications), to manage symptoms.