Association between Stress and Gastroesophageal Reflux Disease (GERD) Among Undergraduate Students in Peshawar: A Cross-Sectional Study

Stress and GERD Among Undergraduate Students

Abstract

Gastroesophageal reflux disease (GERD) and stress are growing health concerns among undergraduate students, especially in high-pressure academic settings. However, limited data exist regarding their prevalence and associated factors among students in Peshawar. Objective: To determine the association between Stress and GERD and identify its associated risk factors among undergraduate students in Peshawar. Methods: A cross-sectional study was conducted among 384 undergraduate students in Peshawar using convenience sampling. Data were collected through a structured questionnaire incorporating the validated GERD-Q and Cohen’s Perceived Stress Scale (PSS-10). Results: Of the 384 students, 88% were medical, and 12% were non-medical.PSS-10 scores showed 15.4% low stress, 71.1% moderate stress, and 13.5% high stress. Perceived stress was significantly associated with gender (p= 0.021) and academic performance (p= 0.011). Smoking was associated with GERD (p=0.030), with smokers showing a higher moderate-to-severe GERD. Frequent fast-food consumption was also significantly associated with GERD (p=0.014), and weekly or daily consumers had 79%-89% likelihood of GERD. Spearman’s correlation showed a weak but statistically significant association between perceived stress levels and GERD severity (p=0.014). Conclusions: This study revealed a high burden of moderate to high stress and significant GERD prevalence among undergraduate students in Peshawar. Stress was strongly associated with greater GERD severity and was more common in females and lower academic performers. GERD was significantly associated with smoking, frequent fast-food intake, early academic years, limited physical activity, and NSAID use. College-based interventions focusing on stress management, smoking cessation, healthy eating, and physical activity are recommended.