Meta-analysisindependent cross-checkabstract checked I-SRC-124 standard review
Reflux risk factors in Saudi Arabia
Prevalence and risk factors of gastro-oesophageal reflux disease in Saudi Arabia: a systematic review and meta-analysis.
Overview
Alhafid IA et al.. BMJ Open 2026 · PMID 42303406 · DOI 10.1136/bmjopen-2026-118665
Painkillers and smoking were linked to reflux; frequent tea or coffee drinking was not.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Find reflux risk factors in the Gulf
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
14 studies
- What was actually found?
Smoking and NSAIDs, not tea/coffee
- How large was the observed effect?
31.6% vs 31.3% prevalence
- What do the results mean in everyday life?
Tea is not a main reflux cause
- What are the study's limitations?
Heterogeneous data
- What does it say about Elawady's specific claim?
Contradicts the claim (regional)
- Do the results apply to Germany and Europe?
High for Arab region
Scientific in-depth review
1. Full reference
- Authors
- Alhafid IA et al.
- Journal
- BMJ Open
- Year
- 2026
- Identifier
- PMID 42303406 DOI 10.1136/bmjopen-2026-118665
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works record checked; dietary-factor results read in Europe PMC full text PMC13288702
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
None declared.
2. Research question
What are the prevalence and risk factors of GERD in Saudi Arabia and other GCC countries?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of prevalence studies
- Population
Adults in Saudi Arabia
- Country
Saudi Arabia
- Period
Searches without date limits; published 2026
- Sample size
14 studies, 17,927 participants
- Inclusion and exclusion criteria
Cross-sectional GERD prevalence studies
4. Methods and endpoints
- Exposure / intervention
Risk factors incl. frequent coffee/tea
- Comparator
Non-frequent
- Endpoints
GERD prevalence; odds ratios
- Statistical methods
Random-effects meta-analysis; JBI appraisal
5. Actual results
- Results
Pooled GERD prevalence 32% (22%-44%; I2 99.4%). NSAIDs (OR 1.78) and smoking (OR 1.59) increased odds. Frequent coffee/tea: GERD prevalence 31.6% vs 31.3%; not a significant risk factor (full text).
- Absolute risks
not applicable
- Authors' conclusion
GERD is common in Saudi Arabia; NSAIDs and smoking are associated risk factors.
6. Strengths
- Regional (Arab) data
- Registered protocol
7. Weaknesses
- Extreme heterogeneity
- Coffee and tea combined; self-reported
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Heterogeneous cross-sectional studies.
9. Assessment of the statistical interpretation
31.6% vs 31.3%: no meaningful difference (stats/C-SRC-24_tea.py).
10. Relevance to the specific claim
Arab-region data: frequent coffee/tea drinking was not a risk factor for reflux, unlike smoking and painkillers.
11. Independent contrary findings
12. Transferability to Germany and Europe
Regional relevance to Egypt (similar tea habits) is higher than East Asian data.
13. Overall methodological judgement
Regional null finding.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |