Prevalence and risk factors for gastroesophageal reflux disease in the Indian population: A meta-analysis and meta-regression study

Indian J Gastroenterol. 2021 Apr;40(2):209-219. doi: 10.1007/s12664-020-01104-0. Epub 2021 Jan 6.


Background: Indian population-based studies on the prevalence and risk factors for gastroesophageal reflux disease (GERD) are scanty, and a meta-analysis and a meta-regression of prevalence and risk factors based on the existing data have not yet been reported.

Methods: A systematic review of all the available publications from India reporting data regarding prevalence and risk factors of GERD was performed. Heterogeneity was assessed using I2 statistics. The meta-analysis was undertaken to measure the average proportion reported in the existing studies, and meta-regression models were used to explore the risk factors for it.

Results: The nine studies included 20,614 subjects; the prevalence of GERD ranged from 5% to 28.5%. The summary effect size (weighted average proportion) estimated by meta-analytic model was 0.1415 (95% confidence interval [CI] 0.099 to 0.197). The results for the test of heterogeneity that included tau2 (0.37, 95% CI 0.21 to 1.80), I2 (98.9%, 95% CI 98.01 to 99.77), and the Q-statistic (707.670; p < 0.0001) suggested high heterogeneity in the effect sizes. The pooled proportion of GERD (random-effects model) was 15.573 (95% CI 11.046 to 20.714). In the meta-regression model, sample size (p = 0.005) explained about 50% of the heterogeneity.

Conclusion: The pooled prevalence of GERD in the Indian population is 15.6 (95% CI 11.046 to 20.714). The risk factors were age, body mass index (BMI), non-vegetarian diet, tea/coffee intake, tobacco, and alcohol consumption. However, there was significant heterogeneity in the studies.

Keywords: Acid peptic disease; Diet; Esophagitis; Heartburn; Population prevalence; Reflux; Risk factors; Tobacco.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Body Mass Index
  • Gastroesophageal Reflux* / epidemiology
  • Humans
  • Prevalence
  • Risk Factors
  • Tobacco Use