{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:47:18Z","timestamp":1777556838517,"version":"3.51.4"},"reference-count":37,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T00:00:00Z","timestamp":1617667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Gastroesophageal reflux disease (GERD) is one of the most common diseases. It mainly causes the stomach contents to flow back to the esophagus, thereby stimulating the esophagus and causing discomfort. From the results of our research, we intend to provide the general public with information related to preventing gastroesophageal reflux disease and medical personnel with information on the treatment and care of patients with gastroesophageal reflux disease. This study aimed to investigate the association of lifestyle habits and perceived symptoms on GERD in patients who underwent routine health check-ups. This study was conducted as a retrospective cross-sectional design to collect GERD cases from the medical records containing the health questionnaires and the report of endoscopic findings on the day of the health check-up. A total of 5653 patients were enrolled between 1 January 2016, and 31 December 2018. About 60.2% (n = 3404) of patients with GERD were diagnosed based on endoscopic findings. Descriptive and multivariate logistic regression analyses were performed to identify the risk factors of the development of GERD. The results of the multivariate logistic regression analysis showed that age, sex, waist circumference, Areca catechu chewing habit, sleep disorders, otolaryngology symptoms, and hepatobiliary and gastrointestinal symptoms were significantly associated with GERD. In this study, our results can be used as a reference for public health care and clinicians. Because most GERD cases can be controlled and prevented by lifestyle modifications, health professionals should always obtain a detailed history regarding symptoms and lifestyle habits associated with GERD.<\/jats:p>","DOI":"10.3390\/ijerph18073808","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T06:05:43Z","timestamp":1617689143000},"page":"3808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Associations between Lifestyle Habits, Perceived Symptoms and Gastroesophageal Reflux Disease in Patients Seeking Health Check-Ups"],"prefix":"10.3390","volume":"18","author":[{"given":"Chiu-Hua","family":"Chang","sequence":"first","affiliation":[{"name":"Nursing Department, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"Department of Healthcare Administration, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-8168","authenticated-orcid":false,"given":"Tai-Hsiang","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Management, Yuan Ze University, Taoyuan 32003, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan-Lung (Luke)","family":"Chiang","sequence":"additional","affiliation":[{"name":"College of Management, Yuan Ze University, Taoyuan 32003, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiao-Lin","family":"Hsu","sequence":"additional","affiliation":[{"name":"Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"Department of Nursing, Meiho University, Pingtung 912009, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsien-Chung","family":"Yu","sequence":"additional","affiliation":[{"name":"Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"},{"name":"Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan"},{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang-Yuan","family":"Mar","sequence":"additional","affiliation":[{"name":"Graduate Institute of Health Care, Meiho University, Pingtung 912009, Taiwan"},{"name":"Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Chung","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration, I-Shou University, Kaohsiung 82445, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s10552-009-9458-0","article-title":"Increasing trend of the incidence of esophageal squamous cell carcinoma, but not adenocarcinoma, in Taiwan","volume":"21","author":"Lu","year":"2010","journal-title":"Cancer Causes Control"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1053\/j.gastro.2017.07.045","article-title":"Presentation and Epidemiology of Gastroesophageal Reflux Disease","volume":"154","author":"Richter","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.soc.2009.03.005","article-title":"Risk factors for esophageal cancer development","volume":"18","author":"Falk","year":"2009","journal-title":"Surg. Oncol. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1245\/s10434-007-9392-x","article-title":"Photodynamic therapy with curative intent for Barrett\u2019s esophagus with high grade dysplasia and superficial esophageal cancer","volume":"14","author":"Keeley","year":"2007","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1111\/nyas.13850","article-title":"Current and future perspectives in the management of gastroesophageal reflux disease","volume":"1434","author":"Akiyama","year":"2018","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1440-1746.2010.06534.x","article-title":"Gastroesophageal reflux disease in Asia: A historical perspective and present challenges","volume":"26","author":"Goh","year":"2011","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1097\/MCG.0b013e31809e7126","article-title":"Prevalence and clinical characteristics of Barrett\u2019s esophagus in a Chinese general population","volume":"42","author":"Tseng","year":"2008","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.1553-2712.2004.tb01433.x","article-title":"Advanced statistics: Understanding medical record review (MRR) studies","volume":"11","author":"Worster","year":"2004","journal-title":"Acad. Emerg. Med. Off. J. Soc. Acad. Emerg. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"310","DOI":"10.15171\/mejdd.2016.41","article-title":"Review of Clinical Spectrum of Gastroesophageal Reflux Disease in a General Population; A Study from South-East Iran","volume":"8","author":"Darvishmoghadam","year":"2016","journal-title":"Middle East J. Dig. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5499","DOI":"10.19082\/5499","article-title":"Gastroesophageal reflux disease among population of Arar City, Northern Saudi Arabia","volume":"9","author":"Alsulobi","year":"2017","journal-title":"Electron. Physician"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1111\/j.1365-2036.2006.02924.x","article-title":"Prevalence and sociodemographics of reflux symptoms in Germany\u2013results from a national survey","volume":"23","author":"Nocon","year":"2006","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1365-2036.2008.03708.x","article-title":"Epidemiological study of gastro-oesophageal reflux disease: Reflux in spouse as a risk factor","volume":"28","author":"Mofid","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-62795-1","article-title":"Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): Systematic review with meta-analysis","volume":"10","author":"Nirwan","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_14","first-page":"e10535","article-title":"Prevalence and Determinants of Gastroesophageal Reflux Disease and the Risk Factors Among Adult Patients Attending Al-Iskan Primary Health Care Center in Makkah, 2020","volume":"12","author":"Halawani","year":"2020","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e158","DOI":"10.3346\/jkms.2019.34.e158","article-title":"Gender specific differences in prevalence and risk factors for gastro-esophageal reflux disease","volume":"34","author":"Kim","year":"2019","journal-title":"J. Korean Med. Sci."},{"key":"ref_16","first-page":"605","article-title":"Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study","volume":"54","author":"Adekanle","year":"2018","journal-title":"Alex. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1136\/gut.2006.109413","article-title":"Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms","volume":"56","author":"Corley","year":"2007","journal-title":"Gut"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/0971-5851.133702","article-title":"A review of the systemic adverse effects of areca nut or betel nut","volume":"35","author":"Garg","year":"2014","journal-title":"Indian J. Med. Paediatr. Oncol. Off. J. Indian Soc. Med. Paediatr. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Hsieh, Y.H., Wu, M.F., Yang, P.Y., Liao, W.C., Hsieh, Y.H., Chang, Y.J., and Lin, I.C. (2019). What is the impact of metabolic syndrome and its components on reflux esophagitis? A cross-sectional study. BMC Gastroenterol., 19.","DOI":"10.1186\/s12876-019-0950-z"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wang, H.Y., Leena, K.B., Plymoth, A., Hergens, M.P., Yin, L., Shenoy, K.T., and Ye, W. (2016). Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India. BMC Gastroenterol., 16.","DOI":"10.1186\/s12876-016-0452-1"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1163\/1568560042342310","article-title":"Role of histamine and acid back-diffusion in modulation of gastric microvascular permeability and haemorrhagic ulcers in betel-quid-fed rats","volume":"12","author":"Chen","year":"2004","journal-title":"Inflammopharmacology"},{"key":"ref_22","first-page":"2461","article-title":"Epidemiologic risk factors for esophageal cancer development","volume":"12","author":"Mao","year":"2011","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_23","first-page":"297","article-title":"Risk factors for gastroesophageal reflux disease: The role of diet","volume":"9","author":"Jarosz","year":"2014","journal-title":"Prz. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/00365521.2016.1224383","article-title":"Associations among gastroesophageal reflux disease, psychological stress, and sleep disturbances in Japanese adults","volume":"52","author":"Okuyama","year":"2017","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"22","DOI":"10.5056\/jnm.2010.16.1.22","article-title":"Gastroesophageal reflux disease and sleep disorders: Evidence for a causal link and therapeutic implications","volume":"16","author":"Jung","year":"2010","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s00535-008-2235-0","article-title":"Nationwide epidemiological study on gastroesophageal reflux disease and sleep disorders in the Japanese population","volume":"43","author":"Kusano","year":"2008","journal-title":"J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.5665\/sleep.5976","article-title":"Gastroesophageal Reflux and Sleep Disturbances: A Bidirectional Association in a Population-Based Cohort Study, the HUNT Study","volume":"39","author":"Lindam","year":"2016","journal-title":"Sleep"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/S2468-1253(19)30412-1","article-title":"The effect of sleep on gastrointestinal functioning in common digestive diseases","volume":"5","author":"Orr","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/00365521.2018.1553062","article-title":"Gastroesophageal reflux symptoms and microscopic esophagitis in a cohort of consecutive patients affected by atrophic body gastritis: A pilot study","volume":"54","author":"Carabotti","year":"2019","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.mehy.2015.06.007","article-title":"Associations between peripheral vertigo and gastroesophageal reflux disease","volume":"85","author":"Vaitkus","year":"2015","journal-title":"Med. Hypotheses"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s00405-008-0770-1","article-title":"Pathophysiological mechanisms of extraesophageal reflux in otolaryngeal disorders","volume":"266","author":"Schreiber","year":"2009","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1017\/S0022215114001030","article-title":"Tinnitus and its association with psychiatric disorders: Systematic review","volume":"128","author":"Pinto","year":"2014","journal-title":"J. Laryngol. Otol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.smrv.2012.04.003","article-title":"Tinnitus and insomnia: Is hyperarousal the common denominator?","volume":"17","author":"Schredl","year":"2013","journal-title":"Sleep Med. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1053\/j.gastro.2004.03.077","article-title":"Gastroesophageal reflux among different racial groups in the United States","volume":"126","author":"Petersen","year":"2004","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: A systematic review","volume":"63","author":"Sweet","year":"2014","journal-title":"Gut"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.cgh.2007.02.033","article-title":"Determinants of gastroesophageal reflux disease in adults with a history of childhood gastroesophageal reflux disease","volume":"5","author":"Richardson","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/j.1651-2227.1995.tb13759.x","article-title":"Development of stomach-ache and headache during middle childhood: Co-occurrence and psychosocial risk factors","volume":"84","author":"Borge","year":"1995","journal-title":"Acta Paediatr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3808\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:11:22Z","timestamp":1760364682000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,6]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["ijerph18073808"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18073808","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,6]]}}}