Perceived stress, diet, and medication use associated with GERD symptoms in Lebanese adults: A cross-sectional study.

Background: Gastroesophageal reflux disease (GERD) is a common condition influenced by lifestyle, clinical, and psychosocial factors. This study examined the relationship between GERD symptoms and perceived stress among Lebanese adults, while accounting for key demographic, dietary, and clinical variables. Method: A cross-sectional study was conducted among Lebanese adults between January and September 2024 using an online self-administered questionnaire. GERD symptoms and perceived stress were assessed using the GERDQ and PSS-10 scales. Bivariate analyses followed by multivariable logistic regression were performed to identify factors independently associated with GERD symptoms. Results: A total of 440 participants were included (mean age of 36.4 ± 16.96 years), of whom 28.4% had probable GERD symptoms. Most participants (83.2%) reported moderate stress levels with a mean PSS score of 19.74±5.05. Higher perceived stress was independently associated with increased odds of GERD symptoms (ORa=1.110). Additional correlates included dietary factors (frequent intake of fatty/fried foods, carbonated beverages, and caffeinated drinks), medication-related factors (NSAIDs, bisphosphonates, and iron supplements), former smoking, and a personal or family history of gastrointestinal disease. Being married was associated with lower odds of GERD symptoms. Conclusion: Probable GERD symptoms were independently associated with perceived stress, dietary habits, smoking history, medication use, and gastrointestinal disease history. These findings support a biopsychosocial understanding of GERD symptom burden and provide further evidence that psychosocial factors should be considered when investigating gastrointestinal health in vulnerable populations.