European Journal of Cardiovascular Medicine

Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the reflux of gastric contents into the esophagus, leading to symptoms such as heartburn and regurgitation. It is a significant public health concern, with growing global prevalence attributed to changing dietary habits, sedentary lifestyles, and increasing obesity rates. While GERD has traditionally been viewed as more common among older adults, recent studies have shown a rising incidence in younger populations, including university students and young adults [1,4].

The etiology of GERD is multifactorial, with numerous lifestyle factors implicated in its development. Smoking, alcohol consumption, irregular meal patterns, high-fat or spicy diets, and physical inactivity have been associated with an increased risk of GERD symptoms [2,3,5]. Furthermore, emerging evidence suggests that even genetic predispositions and shared environmental factors, as seen in monozygotic twin studies, contribute to GERD pathogenesis [5].

In the Indian context, population-based studies have reported a notable prevalence of GERD and identified modifiable risk factors such as obesity and dietary behavior as key contributors [6]. However, despite growing recognition of the disease burden, there is a paucity of community-level data focusing specifically on GERD in younger adults, particularly in semi-urban or rural Indian settings.

Therefore, this study was undertaken to assess the prevalence of GERD symptoms among young adults in a community setting and to explore the association between GERD and various lifestyle-related risk factors.

Study Design and Setting:

This was a community-based cross-sectional study conducted between August 2023 and May 2024 in the field practice areas affiliated with Government Medical College (GMC), Mahbubabad, Telangana, India.

Study Population:

The study included young adults aged 18 to 35 years residing in the selected communities. Individuals who had a history of gastrointestinal surgery, known peptic ulcer disease, or were on long-term proton pump inhibitors or H2 blockers were excluded from the study.

Sample Size and Sampling Technique:

A total of 100 participants were selected using a simple random sampling method. The sample size was calculated considering a presumed prevalence of GERD symptoms among young adults with a margin of error of 10% and confidence level of 95%.

Data Collection Tools:

Data were collected using a pre-tested, semi-structured questionnaire, which included sections on sociodemographic details, lifestyle habits (smoking, alcohol consumption, dietary preferences, physical activity), and GERD symptoms. GERD symptoms were assessed using a validated symptom questionnaire that included the frequency and severity of heartburn and regurgitation.

Operational Definition:

Participants were classified as having GERD if they reported experiencing heartburn and/or regurgitation at least twice per week.

Ethical Considerations:

Ethical approval for the study was obtained from the Institutional Ethics Committee of GMC Mahbubabad. Written informed consent was obtained from all participants prior to inclusion.

Statistical Analysis:

Data were entered and analyzed using Microsoft Excel and SPSS version 26.0. Descriptive statistics were used to summarize demographic variables. The association between GERD symptoms and lifestyle factors was assessed using the Chi-square test, and a p-value of <0.05 was considered statistically significant.

A total of 100 young adults participated in the study, comprising 56 males (56%) and 44 females (44%). The mean age of the participants was 24.7 ± 4.2 years (Table 1).

Table 1: Demographic Characteristics of the Study Population (N = 100)

The prevalence of gastroesophageal reflux disease (GERD) symptoms among the participants was found to be 29% (n = 29). Heartburn was the most commonly reported symptom, present in 24% of individuals, followed by regurgitation in 20%. Among those with GERD symptoms, 62.1% experienced symptoms at least twice per week. In terms of symptom severity, 41.4% had mild symptoms, 37.9% moderate, and 20.7% reported severe symptoms (Table 2).

Table 2: Prevalence and Severity of GERD Symptoms

Analysis of lifestyle factors revealed significant associations with the presence of GERD symptoms. Smoking was reported in 34.5% of participants with GERD compared to 11.3% without (p = 0.006). Alcohol consumption, frequent intake of spicy food, late-night meals, higher BMI (>25 kg/m²), and physical inactivity were all significantly associated with the presence of GERD symptoms (p < 0.05 for all) (Table 3).

Table 3: Association of Lifestyle Factors with GERD Symptoms

*Significant at p < 0.05

Gender-wise comparison showed a higher prevalence of GERD symptoms among males (32.1%) compared to females (25.0%), although this difference was not statistically significant (p = 0.42) (Table 4).

Table 4: Gender-wise Distribution of GERD Symptoms

This community-based cross-sectional study found that 29% of young adults reported symptoms suggestive of gastroesophageal reflux disease (GERD), with heartburn and regurgitation being the most prevalent complaints. These findings are consistent with previous community-based studies in Southern India and Iran, which documented GERD prevalence rates ranging between 18% and 30% in adult and young adult populations [6,11].

Our study identified several modifiable lifestyle factors significantly associated with GERD, including smoking, alcohol consumption, high BMI, late-night meals, frequent intake of spicy food, and physical inactivity. These findings align with a growing body of evidence highlighting lifestyle and behavioral contributors to GERD pathophysiology [7,8]. In particular, late-night eating and high-fat/spicy diets may lower lower esophageal sphincter tone and delay gastric emptying, thereby facilitating reflux.

Psychological stress has also emerged as an important factor influencing GERD symptoms. A study among Egyptian university students demonstrated a strong link between stress, irregular sleep patterns, and increased GERD symptom burden [9]. Although psychological variables were not directly assessed in our study, such associations warrant further investigation in future research.

Globally, the clinical presentation and burden of GERD have been shifting, with more cases now reported in younger, otherwise healthy individuals, especially in rapidly urbanizing regions [10]. Cultural practices, health literacy, and attitudes toward self-medication also appear to influence GERD prevalence and management, as seen in population-based studies from Pakistan and Albania [8,12].

Taken together, these findings highlight the need for targeted public health interventions focused on lifestyle modifications and early identification of at-risk individuals to reduce the growing burden of GERD in young adults.

This study highlights a significant burden of gastroesophageal reflux disease (GERD) symptoms among young adults, with nearly one-third reporting typical symptoms such as heartburn and regurgitation. The findings underscore the strong association between GERD and modifiable lifestyle factors, including smoking, alcohol use, consumption of spicy food, late-night eating habits, obesity, and physical inactivity. These results emphasize the need for increased awareness and early intervention strategies targeted at lifestyle modification in this age group. Community-based health education programs focusing on dietary practices and healthy behaviors may play a crucial role in reducing the prevalence and impact of GERD among young adults in similar populations.

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