Prevalence and Severity of Gastroesophageal Reflux Disease in Adults Using Gastroesophageal Reflux Scintigraphy

Abstract

Background & objectives: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder with variable association with age, sex and body mass index (BMI). This study aimed to assess the prevalence and severity of GERD in symptomatic patients and examine its relationship with demographic and anthropometric parameters. Methods: In this prospective observational study, 54 symptomatic adults (24 males, 30 females; mean age 40.4±14.2years) underwent GERS using a technetium-99m sulfur colloid capsule. Reflux severity was graded scintigraphically. Patients were stratified by WHO BMI and age groups. Data were analyzed using standard statistical methods; P < 0.05 was considered significant. Results: GERD was detected in 66.7% of participants, with a higher prevalence in females (70%) than males (62.5%). The mean age was 40.4 yr. Although the highest prevalence was observed in the 15-24year age group (87.5%), differences across age groups were not statistically significant. GERD positivity was highest among underweight individuals (88.9%), followed by normal weight (65.4%), overweight (60%) and obese (50%) categories. Grade III reflux was more frequent in underweight and overweight groups. Interpretation & conclusions: GERD was common irrespective of age, sex or BMI. While obesity remains a known risk factor, significant reflux also occurred in underweight and non-obese individuals, indicating that BMI alone is not a reliable predictor. Larger studies using advanced diagnostic modalities are needed to clarify these associations.

Introduction

GERD is a common condition where stomach contents flow back into the esophagus, causing symptoms like heartburn and regurgitation and sometimes leading to esophageal damage. Its development is influenced by multiple factors such as age, sex, body mass index (BMI), and conditions like hiatal hernia, with obesity traditionally considered a major risk factor. However, recent evidence suggests GERD can also occur in underweight or normal-weight individuals, and symptom patterns may differ between men and women.

This study used gastroesophageal reflux scintigraphy (GERS) to assess GERD in symptomatic adults and examine how age, sex, and BMI relate to disease prevalence and severity. It was a prospective study of 54 patients out of 112 screened, conducted between 2019 and 2023.

Overall, GERD was detected in 66.7% of patients. Females showed slightly higher positivity (70%) than males (62.5%). Surprisingly, the highest GERD prevalence was seen in underweight individuals (88.9%), though differences across BMI groups were not statistically significant. Age-wise, GERD was present across all groups, with the highest rate in the youngest group (15–24 years), while more severe (Grade III) reflux was seen mainly in middle-aged adults (25–59 years).

References

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Copyright © 2026 Dr. Amandeep Kaur. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.