PREVALENCE OF REFLUX IN AMERICA: TIMES SQUARE STUDY (PRELIMINARY DATA)*
Jamie A. Koufman, M.D. and Greg VanHorn, B.A.
From The Voice Institute of New York │ www.voiceinstituteny.com
Background: The prevalence of reflux-related diseases is unknown; however, it is clear that not all refluxers have classic gastroesophageal reflux disease (GERD). Many people have exrtraesophageal symptoms and manifestations without having heartburn or indigestion. The latter group has laryngopharyngeal reflux (LPR), also called “silent reflux.” The purpose of this study was to estimate the prevalence of reflux (LPR and GERD) in the American population.
Materials & Methods: Trained interviewers were sent to Times Square to randomly interview adult (over 18 years) U.S. citizens, most of whom were standing near the pedestrian plazas surrounding the TKTS discount theater line. The questionnaires were completed by interviewers and not by the subjects. The questionnaire contained 24 questions and was usually completed in 2-3 minutes per respondent.
Results: Of the 656 study subjects, 55% were female and 45%) were male. The mean age of the study population was 41 ± 18.4 years (range 18-89 years). Twenty-two percent (131/656) were self-identified refluxers, and another 18% (118/656) had two or more reflux symptoms and/or took reflux medications despite not having a known diagnosis. (The latter were termed “silent refluxers”) Of the 249 subjects with reflux, 55% were female and 45% were male. The mean age of the refluxers was 42 ± 17.9 years (range 18-82 years). Within the reflux group, the most common symptoms (in decreasing order of occurrence) were: Heartburn 62%, indigestion 44%, post-nasal drip 33%, morning hoarseness and sore throat 21%, chronic throat clearing 20%, hoarseness 14%, chronic cough 14%, a sensation of a lump in the throat 13%, difficulty swallowing 13%, and choking episodes 8%.
With the above data analysis, there were no significant differences between men and women, between caucasians and non-caucasians, nor were there significant differences between the different age groups; 18 to 29 years 37%, 30-39 years 31%, 40-49 years 43%, 50-59 years 44%, 60-69 years 41%, and over 70 years 43%.
Conclusions: The data, representing a reasonable geographic distribution of the United States, reveal that 40% have symptoms of reflux. Assuming that the population of the U.S, is 320 million, then as many as 128 million Americans may suffer from reflux. In addition, almost half of the subjects with reflux had silent/undiagnosed reflux.
This paper has not yet been presented nor submitted for publication. This is a preliminary report of the data. (At present, there are over 1,000 respondents being analyzed. J. Koufman, M.D.
Key words: Gastroesophageal reflux, GERD, laryngopharyngeal reflux, LPR, acid reflux, prevalence of reflux, American population, heartburn, indigestion, hoarseness, post-nasal drip.