A 13-nation population survey of upper gastrointestinal symptoms: Prevalence of symptoms and socioeconomic factors

Abstract

Background: Previous data collected in separate studies using various different survey instruments have suggested some variability in the prevalence of symptoms between nations. However, there is a lack of studies which assess and compare the prevalence of upper gastrointestinal symptoms contemporaneously in various countries using a uniform, standardised method. Aim: To determine the prevalence of upper gastrointestinal (UGI) symptoms in 13 European countries, and the association between socioeconomic factors and symptoms using a standardised method. Methods: A representative age- and gender-stratified sample of 23 163 subjects (aged 18–69 years) was surveyed. Results: The prevalence of UGI symptoms was 38%. UGI symptoms were most prevalent in Hungary [45%, 95% confidence interval (CI): 42.2–48.4] and lowest in the Netherlands (24%, 95% CI: 21.0–26.2). UGI symptoms were more prevalent in women (39%, 95% CI: 38.4–39.6) vs. men (37%, 95% CI: 36.4–37.6). Heartburn (24%, 95% CI: 23.4–24.6) and acidic reflux (14%, 95% CI: 13.6–14.4) were most common. With age, the prevalence of UGI symptoms decreased (e.g. 18–29 years: 43%, 95% CI: 41.4–44.3 vs. 50–69 years: 33%, 95% CI: 32.3–34.4); in contrast, the frequency of symptom episodes/year increased with age (e.g. 18–29 years: 11.3 episodes per years, 95% CI: 10.5–12.1 vs. 50–69 years: 21.8, 95% CI: 20.7–22.9). Socioeconomic status as measured by gross domestic product was inversely associated with symptoms and in total, socioeconomic factors, gender, body mass index, smoking habits and alcohol consumption explained 83% of the variance of UGI symptoms. Conclusions: There are marked differences in the country specific prevalence of upper gastrointestinal complaints. Socioeconomic factors are closely associated with the prevalence of upper gastrointestinal symptoms.