Prevalence and Associated Risk Factors of Gastro esophageal Reflux Disease amongUniversity Students in Saudi Arabia

Abstract

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder characterized by the reflux
of stomach contents into the esophagus, leading to irritation and potential complications such as Barrett’s esophagus,
esophageal stricture, and esophageal adenocarcinoma. Globally, its prevalence ranges from 10% to 30%, while studies
in Saudi Arabia report higher rates between 23.5% and 45.4%. University students are considered a high-risk group due
to lifestyle factors such as irregular eating patterns, excessive caffeine intake, stress, and poor sleep quality. Objectives:
This study aimed to determine the prevalence of GERD and its associated risk factors among university students in Saudi
Arabia. Methods: This descriptive cross-sectional study will be conducted in Saudi Arabia between July and December
2025. The target population includes Saudi undergraduate students aged 18–25 years. Participants will be recruited
through a convenience sampling technique using an online self-administered questionnaire distributed via social media
platforms. The questionnaire consists of three sections: demographic information, lifestyle and dietary habits, and
the validated GERDQ tool to assess GERD symptoms. Inclusion criteria are Saudi nationality, age 18–25 years, and
current university enrollment. Exclusion criteria include pregnancy, non-Saudi nationality, non-university status, other
gastrointestinal diseases, and the use of acid-suppressive medications for unrelated conditions. The minimum sample size
of 384 participants was calculated using the Raosoft sample size calculator, assuming a 5% margin of error and a 95%
confidence level. Data will be entered in Microsoft Office Excel (2024) and analyzed using the Statistical Package for
the Social Sciences version 28. A pilot test with 20 participants will be performed to ensure clarity and feasibility; pilot
responses will be excluded from the primary analysis. Results: The mean age of the participants was 20.58 years, with
a standard deviation of 1.69 years, and the majority were female, accounting for 82.9% of the group. The rate of GERD
occurrence was 36.6%. A significant number of participants indicated that they regularly consume coffee (67.1%), fast
food (58.1%), and tea (47.1%), whereas 35.6% stated that they do not engage in regular physical activity. The logistic
regression analysis indicated that individuals with a normal body mass index had significantly lower odds of experiencing
GERD compared to those who were obese (odds ratio [OR] = 0.277, P = 0.001). Smoking (OR = 0.372, P = 0.001)
and a family history of GERD (OR = 0.418, P = 0.001) were significant independent factors associated with a higher
risk of developing GERD. Students studying health or medical fields had notably lower chances of experiencing GERD
compared to those in other disciplines (OR = 0.523, P = 0.043). Other factors, such as gender, physical activity, meal
frequency, and eating habits, did not show a significant statistical relationship with the outcomes. Conclusion: GERD
is common among university students, and factors
such as obesity, smoking, family history, and
educational background are important influences.
These results highlight the significance of
changing lifestyles, providing health education,
and implementing preventive measures aimed at
young adults to decrease the impact of GERD.