Risks, precipitants and clinical presentation of gastroesophageal reflux disease at the Kilimanjaro christian medical centre in Tanzania

Abstract

Introduction: Risk factors and precipitants of gastroesophageal disease (GERD) differ widely in communities. We conducted an observational study to describe these risks, precipitants and clinical presentation of GERD patients at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. Methods: We consecutively recruited 92 GERD patients referred for endoscopy at KCMC from March to November 2008.Using structured questionnaire risk factors, precipitants and symptoms of GERD were enquired. Their upper gastrointestinal endoscopic findings were as well documented. Results: The mean (± SD) age of the study population was 47.32 (±17) years. Reported symptoms included water brash (37%), dyspepsia (6%), chronic cough (11%) and hemoptysis (5%). More than half (56%) of the patients surveyed identified food precipitants for their GERD symptoms. Triggers of GERD symptoms were boiled beans 19%, spicy food 11%, sour/fermented meals 10%, roasted tomato 9%, silver cyprinid fish (dagaa)5%,beans with cooked green banana (matoke) 2% and fermented milk 1%. Most of the studied patients had normal body mass index (52%), and 25% admitted to be consuming alcohol though they didn’t associate it with their GERD symptoms. The most common endoscopy finding was ‘loose lower esophageal sphincter (85%) . Conclusion: Most GERD patients referred for endoscopy at KCMC were found to have water brash and ‘loose lower esophageal sphincters’ as described by endoscopists to denote mechanical abnormality of the lower esophageal sphincter. GERD symptoms were precipitated by common locally available food and spices.