{
  "abstract": "Objective To estimate the pooled prevalence and associated factors of gastro-oesophageal reflux disease (GERD) in Saudi Arabia and other Gulf Cooperation Council (GCC) countries.Design Systematic review and meta-analysisData sources Searches were carried out in Web of Science, Scopus, PubMed, Google Scholar and Dimensions AI with no date or language filters.Eligibility criteria for selection of studies Cross-sectional studies that reported estimates of GERD prevalence from Saudi Arabia and other GCC countries were included.Data extraction and synthesis Two reviewers independently extracted the data, and the accuracy and clarity of the final extracted data were cross-checked by another two reviewers. Study quality was assessed using JBI Critical Appraisal Tool for Prevalence Studies. Random-effects model was used for meta-analyses.Results Fourteen studies from Saudi Arabia met the inclusion criteria (total participants=17 927); from the other GCC countries, only one study from Bahrain and none from Qatar, United Arab Emirates, Kuwait or Oman met the inclusion criteria, and thus were not included in the pooled analysis. The pooled prevalence of GERD from Saudi Arabia was 32% (95% CI 22% to 44%); however, there was substantial heterogeneity ( I² = 99.4%). In subgroup analysis to account for heterogeneity, the prevalence was found to be significantly lower when endoscopy findings were used as the diagnostic criteria (13% (95% CI 10% to 16%); τ2=0.028; I² = 93.4%) compared with Gerd-Q questionnaire (33% (95% CI 24% to 43%); τ2=0.54; I² = 98.6%) (p<0.0001). Similar findings were noted based on study quality: high, 26% (95% CI 17% to 36%); moderate, 49% (95% CI 32% to 66%) (τ2=0.87, I² = 99.3%) (p=0.0185). Factors that increased the odds of GERD were non-steroidal anti-inflammatory drugs/analgesics use (OR: 1.78, 95% CI 1.14 to 2.79; p=0.01; τ2=0.09, I² = 59%) and smoking (OR: 1.59, 95% CI 1.28 to 1.99; p<0.0001; τ2=0.03, I² = 33%).Conclusion The pooled prevalence of GERD in Saudi Arabia is 32%. However, given the high heterogeneity, there is a need to standardise methods for better contextualisation of such epidemiological data. Notably, GERD prevalence was significantly lower in high-quality studies and when endoscopy findings were used as the diagnostic criteria. Finally, the lack of GERD prevalence studies from other GCC countries highlights the need for studies to fill this gap.Registration PROSPERO (ID: CRD42023453031)",
  "authors": [
    {
      "affiliations": [
        "College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Ibrahim A Alhafid"
    },
    {
      "affiliations": [
        "College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Mona H Ismail"
    },
    {
      "affiliations": [
        "College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Raed M Alsulaiman"
    },
    {
      "affiliations": [
        "College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Abdulaziz M Alrezuk"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Hatim D Almalke"
    },
    {
      "affiliations": [
        "Vice Presidency for Scientific Research and Innovation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"
      ],
      "name": "Ansaf K Shaikh"
    },
    {
      "affiliations": [
        "Vice Presidency for Scientific Research and Innovation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia"
      ],
      "name": "Anas Abdul Salam"
    },
    {
      "affiliations": [
        "College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia",
        "Division of Gastroenterology, Department of Internal Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia"
      ],
      "name": "Abdulaziz A Al-Quorain"
    }
  ],
  "title": "Prevalence and risk factors of gastro-oesophageal reflux disease in Saudi Arabia: a systematic review and meta-analysis",
  "uid": "73588a9a-7232-5c01-89b5-9a8e584719cd"
}