Incidence and Contributing Factors of Biliary Gastritis in the Kurdistan Region of Iraq

Incidence and Contributing Factors of Biliary Gastritis in the Kurdistan Region of Iraq | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Incidence and Contributing Factors of Biliary Gastritis in the Kurdistan Region of Iraq Araz Omar Fatah, Kochr Ali Mahmood, Saman Taher Barzinjy, Dilshad Hamad Mustafa, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6665067/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and objective Biliary gastritis is a neglected inflammatory disorder caused by bile reflux with a growing incidence worldwide due to lifestyle and dietetic modifications. Regional data are scarce for the Kurdistan Region. To identify the incidence of biliary gastritis and related demographic, lifestyle, dietetic, and clinical factors in the Kurdistan Region among adults. Methods A descriptive cross-sectional study was carried out among 638 adults who were recruited from urban and rural health centers. Data were gathered through structured interviews, medical record review, and clinical examination. Chi-square tests and logistic regression were applied to identify associations between biliary gastritis and different factors, and p ≤ 0.05 was considered significant. Results The incidence of biliary gastritis was 26.7%. Strong correlations existed with female sex, marriage status, nonemployment status, regular use of fast food, low consumption of fruit, consumption of caffeine, gallstones, liver disease, drug abuse, and symptoms of nausea and abdominal pain (p < 0.05). A strong correlation did not exist with diabetes, GERD, or exercise. Patients with ahistory of gastric surgery also had a higher incidence of biliary gastritis. The average age did not differ between the diagnosed and undiagnosed patients (p = 0.063). Conclusion Biliary gastritis is a relevant public health issue in the Kurdistan Region that depends on food consumption habits, comorbidities, and economics. Healthier nutritional interventions should be combined with improved diagnostic access. Biliary gastritis bile reflux food factors gallstones Kurdistan gastrointestinal well-being Figures Figure 1 Figure 2 Introduction Biliary gastritis is a serious and rare inflammatory disease of the gastric mucosa caused by bile reflux into the stomach, which, in most instances, is unnoticed compared with other gastrointestinal disorders. The global incidence of biliary gastritis is on the rise due to dietary transitions and an increase in obesity and gallbladder diseases (1,2). The pathophysiology of biliary gastritis involves impairment of the gastric mucosal barrier due to reflux of bile and duodenal contents. This reflux could be due to obstruction of the bile duct, complications of surgery such as cholecystectomy, or impaired gastric motility (3). These mechanisms suggest that the disease is multifactorial and call for a holistic approach to assessment, including lifestyle, genetic, and environmental considerations (4). The dietary pattern, which is unique to common gastrointestinal conditions such as gallstone diseases in the Kurdistan Region, provides a peculiar context for study (5). Worldwide, high fat and low fiber contents are associated with biliary gastritis because of their roles in promoting bile stasis and sludge formation (6). In Kurdistan, traditional diets rich in animal fats, coupled with limited healthcare access and delayed diagnoses, may increase these risks (Ahmed et al., 2019). Additionally, urbanization and lifestyle shifts have fueled rising obesity and metabolic syndrome rates, further increasing the risk of biliary diseases (7). It is further exacerbated by disparities in healthcare: poor access to endoscopy and laboratory testing in rural Kurdistan leads to underdiagnosis and mismanagement (8). If left unattended, biliary gastritis may lead to severe complications such as peptic ulcers, gastric atrophy, and even gastric cancer (9). The other important factor is genetic predisposition. Variants in genes influencing bile salt metabolism have been associated with increased susceptibility to biliary gastritis (10). Only a few genetic studies have been performed in the Kurdish population, and this area has not been well explored. Genetic influences may provide insights into individual risk and interactions between genetic and environmental factors (11). Cultural practices and healthcare behaviors are both complicated in Kurdistan. Reliance on traditional remedies and delayed medical attention can worsen symptoms and further complicate treatment. Furthermore, infection with Helicobacter pylori , a well-known risk factor for gastrointestinal diseases, may further complicate the understanding of biliary gastritis in this region (12,13). Although research on biliary gastritis has expanded worldwide, few studies have focused on specific regions such as Kurdistan. Certainly, localized research becomes very important in this region because of dietary habits, genetic makeup, and healthcare structure (14). The present study, therefore, attempts to fill the gap in regional research with respect to its incidence and determining key contributing factors. Methodology Study Design and Setting This research employed a descriptive cross-sectional study to determine the incidence and risk factors for biliary gastritis among the population in the Kurdistan Region. The researchers conducted the study between 21st June 2024 and 15th April 2025 in various health centers located in urban and rural areas to gather a representative sample. Study population The research focused on adults who were older than 18 years and who resided in both urban and rural areas of the Kurdistan Region. All participants who met the inclusion criteria and provided consent were included in the study, while those who had past gastric surgery and who refused consent were excluded. Sample size and sampling technique A total of 638 participants were included in the research study. A multistage sampling technique was utilized. The researchers started by selecting major cities and rural areas before randomly choosing healthcare centers located in these areas. A simple random selection method was implemented to choose participants from each center to minimize selection bias (15). Data collection tools and procedures A pretested standardized questionnaire was used to collect data through face‒to-face interviews with the participants. The questions were used in previous studies (16,17,3). The questionnaire contained two sections that examined demographic and lifestyle determinants together with eating habits and gastrointestinal symptoms as well as healthcare utilization and family medical history of gastric illness. Physical measurements such as height and weight were recorded to establish obesity status when needed. The assessment of the clinical history of patients with gallstone-related liver disease and diabetes and drug use was conducted through participant self-reports and medical records access when available. The research assessed both the dietary habits of participants regarding spicy and fast-food consumption along with their caffeine use patterns and their physical activity levels. Symptoms of gastritis were recorded, including nausea, vomiting, heartburn, bloating and abdominal pain. Endoscopic findings that included ulcers and erosions were documented in participants who underwent medical procedures. Ethical considerations This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Prior to data collection, ethical approval was obtained from the Faculty of Medicine, Koya University, under reference number [meeting code 19; paper code17). All participants were informed about the purpose, procedures, potential risks, and benefits of the study, and oral informed consent was obtained from each participant. Confidentiality and anonymity were strictly maintained throughout the study. Participation was entirely voluntary, and participants were assured of their right to withdraw from the study at any time without any negative consequences. Data analysis The descriptive statistics, which included frequency distributions together with percentage means and standard deviations, were calculated. The relationships between biliary gastritis diagnosis and variables, including demographic traits, eating behaviors and comorbidities, were evaluated via chi-square tests together with logistic regression analysis when suitable. The results were considered significant at p ≤ 0.05. The data analysis was conducted with SPSS version 27. Results The demographic and lifestyle factor distributions of the 638 participants are shown in Table 1 . The research study included 56.1% male participants and 43.9% female participants. Most research participants were married couples (78.4%), but 21.6% of the participants remained unmarried. The participants were divided into urban (52.4%) and rural (47.6%) residential areas. The employment status of the participants revealed that 52.7% worked, 44.5% did not work, and 2.8% were students. The sample data revealed that 69.3% of the participants did not smoke, whereas 30.7% of the participants were smokers. The survey results revealed that 95% of the participants did not consume alcohol, whereas 5% admitted to drinking alcohol. The survey results revealed that 73.4% of the participants did not exercise regularly, but 26.6% exercised one to two times per week. The sample participants had an average age of 43.53 years with a standard deviation of 15.25 years, which showed that the sample included participants of diverse ages. Table 1 Frequency and percentage distributions of demographic and lifestyle characteristics of the participants (N = 638) Variable Category Frequency (n) Percent (%) Gender Male 358 56.1 Female 280 43.9 Marital Status Single 138 21.6 Married 500 78.4 Residence Urban 334 52.4 Rural 304 47.6 Occupation Employed 336 52.7 Unemployed 284 44.5 Student 18 2.8 Smoking Status No 442 69.3 Yes 196 30.7 Alcohol Use No 606 95 Yes 32 5 Physical Activity None 468 73.4 1–2 times/week 170 26.6 Mean of age ± S.D 43.53 ± 15.25 The eating patterns of the research participants are presented in Table 2 . The study population revealed that 62.7% never ate spicy foods, but 37.3% ate them at times. The population distribution regarding fast food consumption revealed that 64.9% did not eat fast food, whereas 35.1% did. Most participants (57.7%) reported eating fruit and vegetables infrequently, but 30.1% consumed them weekly, 10% ate them three to four times per week, and only 2.2% ate them daily. The survey results revealed that 53.3% of the participants consumed caffeine rarely, 42.3% consumed it occasionally, and 4.4% reported daily caffeine consumption. Table 2 Frequency and percentage distributions of dietary habits among participants (N = 638) Variable Category Frequency (n) Percent (%) Spicy Food Consumption Never 400 62.7 Rarely 238 37.3 Fast Food Consumption No 414 64.9 Yes 224 35.1 Fruit and Vegetable Intake Rarely 368 57.7 Rarely/Once a Week 192 30.1 3–4 Times per Week 64 10 Daily 14 2.2 Caffeine Intake Rarely 340 53.3 Occasionally 270 42.3 1–2 Times per Day 28 4.4 The incidence rates of gastrointestinal and related medical conditions in the participants are shown in Table 3 . Most (90.6%) did not have gastroesophageal reflux disease (GERD), and 9.4% had been diagnosed with GERD. Peptic ulcer disease was observed in 45.1% of the participants, but 54.9% did not have it. Among the gallstones, 26.6% of the participants had gallstones, and 73.4% had none. Similarly, 11.6% of the respondents had liver disease, whereas 88.4% did not have liver disease. In the context of diabetes, 7.2% of the participants reported that they were diabetic, whereas 92.8% reported that they were not diabetic. With respect to medication use, 64.6% of the respondents were currently on medication, whereas 35.4% were not on medication. Table 3 Distribution of gastrointestinal conditions among participants (N = 638) Variable Category Frequency (n) Percent (%) Gastroesophageal Reflux Disease (GERD) No 578 90.6 Yes 60 9.4 Peptic Ulcer Disease No 350 54.9 Yes 288 45.1 Gallstones No 468 73.4 Yes 170 26.6 Liver Disease No 564 88.4 Yes 74 11.6 Diabetes No 592 92.8 Yes 46 7.2 Taking medication No 226 35.4 Yes 412 64.6 The data presented in Table 4 demonstrate the occurrence of gastritis symptoms among the research participants. The survey results revealed that 15.7% of the participants experienced vomiting and nausea, but 84.3% of the participants did not experience these symptoms. Heartburn symptoms were documented by 18.2% of the participants, but 81.8% of the participants did not experience heartburn. Stomach pain symptoms appeared frequently among the participants because 41.1% of them reported it, but 58.9% of the participants did not experience this symptom. The survey results indicated that bloating symptoms were reported by 15% of the participants, but 85% of the participants did not experience bloating. The survey revealed that 10% of the participants experienced loss of appetite, but 90% of the participants did not. The participants experienced symptoms for three different time periods, with 48.3% reporting less than one month of symptoms and 38.9% reporting symptoms between one and six months and 12.9% reporting symptoms from six months to one year. Table 4 Distribution of Symptoms Related to Gastritis (N = 638) Variable Category Frequency (n) Percent (%) Nausea and Vomiting No 538 84.3 Yes 100 15.7 Heartburn No 522 81.8 Yes 116 18.2 Stomach Pain No 376 58.9 Yes 262 41.1 Bloating No 542 85 Yes 96 15 Loss of Appetite No 574 90 Yes 64 10 Duration of Symptoms < 1 Month 308 48.3 1–6 Months 248 38.9 6 Months – 1 Year 82 12.9 The incidence of biliary gastritis among the participants in the study is shown in Fig. 1 . The total number of participants was 486, 73.3% (n = 356) of whom did not have biliary gastritis, while 26.7% (n = 130) of them had biliary gastritis. This means that although most participants did not have biliary gastritis, a significant proportion above a quarter were affected. These findings highlight the high incidence of biliary gastritis in the study population and the importance of early diagnosis and appropriate treatment protocols since the disease has complications. The data in Table 5 show how often respondents visited healthcare providers and underwent diagnostic tests and endoscopic procedures. The data revealed that 51.4% of the participants visited healthcare providers annually, 37.9% visited them infrequently, 7.8% visited them twice or thrice annually, and only 2.8% visited them more than three times annually. The majority of participants (85.6%) had never received endoscopy or colonoscopy procedures, but 14.4% had actually undergone these tests. The study revealed that 24.5% of the participants had gastric disease in their families, but 75.5% did not have such a history. The study revealed that 38.2% of the participants had experienced melena (dark stool) symptoms in the past, but 61.8% did not have this symptom. The endoscopy results revealed that ulcers were present in 16% of the participants, but 84% had no ulcer findings. The examination revealed gastric erosion in 22.6% of the participants, but 77.4% showed no signs of erosion. Table 5 Distribution of Healthcare Visits, Diagnostic Testing, and Endoscopic Findings among the Participants (N = 638) Variable Category Frequency (n) Percent (%) Frequency of GI Healthcare Visits Rarely 242 37.9 Once a Year 328 51.4 2–3 Times per Year 50 7.8 More Than 3 Times per Year 18 2.8 History of Endoscopy/Colonoscopy No 546 85.6 Yes 92 14.4 Family History of Gastric Disease No 482 75.5 Yes 156 24.5 History of Melena (Dark Stool) No 394 61.8 Yes 244 38.2 Ulcer Findings No 536 84 Yes 102 16 Erosion Findings No 494 77.4 Yes 144 22.6 The analysis presented in Table 6 demonstrates how various demographic elements, together with lifestyle factors, influence biliary gastritis diagnosis among study participants. The female population had a higher biliary gastritis diagnosis rate (32.9%) than the male population did (22.7%) according to the statistical analysis (p = 0.004). The marital status of the respondents was statistically significant (p < 0.001) because married individuals (p = 32.1) received fewer biliary gastritis diagnoses than unmarried participants did (p = 10.1%). The appropriate process: The diagnosis of biliary gastritis did not significantly differ between urban and rural residents (p = 0.367). Occupation status was significantly related to biliary gastritis (p < 0.001) because unemployed patients developed this condition at a rate of 37.3%, whereas working patients developed it at a rate of 19.9%. The students presented unexpected findings because they had no recorded cases of biliary gastritis. The analysis revealed a strong link between smoking history and biliary gastritis diagnosis (p = 0.001), with nonsmokers showing a higher rate (31.2%) than smokers (17.6%). The correlation between alcohol consumption and biliary gastritis diagnosis was extremely high (p < 0.001) because no biliary gastritis cases occurred among drinkers, but 28.7% of nondrinkers developed this condition. Physical exercise was weakly related to biliary gastritis (p = 0.949) because the exercise and nonexercise groups presented similar rates. Table 6 Association between Demographic and Lifestyle Variables and Diagnosed Biliary Gastritis (N = 624) Variable Diagnosed No (n, %) Diagnosed Yes (n, %) p value Gender Male 266 (77.3%) 78 (22.7%) 0.004 Female 188 (67.1%) 92 (32.9%) Marital Status Single 124 (89.9%) 14 (10.1%) < 0.001 Married 330 (67.9%) 156 (32.1%) Residence Urban 238 (71.3%) 96 (28.7%) 0.367 Rural 216 (74.5%) 74 (25.5%) Occupation Employed 258 (80.1%) 64 (19.9%) < 0.001 Unemployed 178 (62.7%) 106 (37.3%) Student 18 (100.0%) 0 (0.0%) Smoking Status No 304 (68.8%) 138 (31.2%) 0.001 Yes 150 (82.4%) 32 (17.6%) Alcohol Use No 422 (71.3%) 170 (28.7%) < 0.001 Yes 32 (100.0%) 0 (0.0%) Physical Activity None 330 (72.7%) 124 (27.3%) 0.949 1–2/week 124 (72.9%) 46 (27.1%) Table 7 shows the relationships between food habits, biliary gastritis, clinical parameters, and the diagnosis of biliary gastritis in the participants. The consumption of spicy food was not significantly correlated with biliary gastritis (p = 0.370), whereas the consumption of fast food was significantly correlated with biliary gastritis (p = 0.005), with fewer cases of biliary gastritis among fast food consumers. Fruit consumption was strongly correlated (p < 0.001) with the highest number of participants with biliary gastritis who ate fruit three to four times a week. Caffeine consumption was also significantly correlated with biliary gastritis (p = 0.010), and an increased incidence was noted in participants who ate caffeine one to two times a day. Gastroesophageal reflux disease (GERD), diabetes, peptic ulcer disease, heartburn, bloating, loss of appetite, and family history of gastric disease were not significantly correlated with biliary gastritis (p > 0.05). Gallstones (p < 0.001), the intake of medications (p < 0.001), and liver disease (p < 0.001) were significantly correlated with increased diagnostic rates of biliary gastritis. Furthermore, nausea and vomiting were strongly correlated with biliary gastritis (p < 0.001), in which half of the patients who experienced these symptoms had the disease. Pain in the abdomen was also highly correlated (p = 0.038), with higher frequencies in those without pain. The number of patients who visited healthcare facilities was also highly correlated with the number of patients with a diagnosis of biliary gastritis (p < 0.001), with those who visited healthcare facilities once a year or more having higher frequencies. Finally, the nature of surgery was significantly related (p < 0.001) to a much greater incidence of biliary gastritis in postgastric surgery patients than in cholecystectomy patients. Table 7 Association between Dietary Habits, Clinical Factors, and Diagnosed Biliary Gastritis (N = 624) Variable Diagnosed No (n, %) Diagnosed Yes (n, %) p value Spicy food Never 276 (71.5%) 110 (28.5%) 0.370 Rarely 178 (74.8%) 60 (25.2%) Fast food No 276 (69.0%) 124 (31.0%) 0.005 Yes 178 (79.5%) 46 (20.5%) Fruit intake Rarely 248 (70.1%) 106 (29.9%) < 0.001 Once a Week 160 (83.3%) 32 (16.7%) 3–4 Times a Week 32 (50.0%) 32 (50.0%) Daily 14 (100.0%) 0 (0.0%) Caffeine Intake Rarely 234 (71.8%) 92 (28.2%) 0.01 Occasionally 206 (76.3%) 64 (23.7%) 1–2 Times a Day 14 (50.0%) 14 (50.0%) Gastroesophageal Reflux Disease No 408 (72.3%) 156 (27.7%) 0.474 Yes 46 (76.7%) 14 (23.3%) Peptic Ulcer Disease No 248 (73.8%) 88 (26.2%) 0.523 Yes 206 (71.5%) 82 (28.5%) Gallstone No 312 (68.7%) 142 (31.3%) < 0.001 Yes 142 (83.5%) 28 (16.5%) Liver Disease No 426 (75.5%) 138 (24.5%) < 0.001 Yes 28 (46.7%) 32 (53.3%) Diabetes No 422 (73.0%) 156 (27.0%) 0.613 Yes 32 (69.6%) 14 (30.4%) Using medication No 198 (93.4%) 14 (6.6%) < 0.001 Yes 256 (62.1%) 156 (37.9%) Nausea and Vomiting No 404 (77.1%) 120 (22.9%) < 0.001 Yes 50 (50.0%) 50 (50.0%) Heartburn No 370 (72.8%) 138 (27.2%) 0.927 Yes 84 (72.4%) 32 (27.6%) Stomach Pain No 252 (69.6%) 110 (30.4%) 0.038 Yes 202 (77.1%) 60 (22.9%) Bloating No 386 (73.1%) 142 (26.9%) 0.645 Yes 68 (70.8%) 28 (29.2%) Loss of Appetite No 404 (72.1%) 156 (27.9%) 0.309 Yes 50 (78.1%) 14 (21.9%) Family History of Gastric Disease No 344 (73.5%) 124 (26.5%) 0.467 Yes 110 (70.5%) 46 (29.5%) Frequency of GI Healthcare Visits Rarely 224 (92.6%) 18 (7.4%) < 0.001 Once a Year 180 (57.3%) 134 (42.7%) 2–3 Times/Year 32 (64.0%) 18 (36.0%) More than 3/Year 18 (100.0%) 0 (0.0%) Type of Surgery Cholecystectomy 362 (79.7%) 92 (20.3%) < 0.001 Gastric Surgery 92 (54.1%) 78 (45.9%) Graph 2 shows the age distribution of the participants according to their diagnosis of biliary gastritis via the independent-samples Mann‒Whitney U test. The mean rank for the nondiagnosed participants was 304.31, and that of the diagnosed participants was 334.36. The p value was 0.063. This implies that age could have a small, although not statistically significant, effect on the probability of being diagnosed with biliary gastritis among this population. Discussion The aim of this research was to identify the incidence and risk factors for biliary gastritis in the population of adults residing in the Kurdistan Region. The incidence rate of biliary gastritis among the subjects was high at 26.7%, which aligns with the rising world trend of disease incidence (18,19). This highlights the need for region-specific epidemiological information, with particular attention given to the common diet, shortages in healthcare access, and culture of the Kurdistan Region. The strongest finding was the strong association of female sex with biliary gastritis, with females having a greater likelihood of being diagnosed than males. This result is consistent with that of Livzan et al. (2023)(3), in which greater biliary reflux and gastritis secondary to the disease were observed in women, perhaps because of hormonal regulation of bile chemistry and gastric motility. Marital status was also associated with the disease, with a greater proportion among married subjects. Marital status, although less frequently noted in earlier literature, can be seen as an indirect marker of lifestyle and stress factors affecting gastrointestinal disease. The relationship between unemployment and high rates of biliary gastritis in this study conflicts with the findings of Mun et al. (2021) (20), who reported a higher prevalence of biliary gastritis among people who work 55 hours a week. A low socioeconomic status is associated with a poor diet, delayed entry into the health system, and a higher incidence of gastrointestinal disease (21). These findings indicate the socioeconomic aspect of disparity in the incidence of biliary gastritis. In terms of diet, fast food consumption was significantly related to biliary gastritis risk. This finding is supported by the studies of Peng et al. (2023) (22), who reported that a high-fat and low-fiber diet leads to bile stasis, delayed gastric emptying, and increased mucosal damage. Consistent with this, the consumption of fruits and vegetables was protective; individuals who consumed fruits and vegetables frequently, particularly three to four times a week, had a reduced incidence of biliary gastritis. This result aligns with that of a previous study, which reported that a diet rich in fibers is involved in defense against bile flow and duodenogastric reflux (23). The consumption of caffeine presented a statistically significant correlation, and increasing daily consumption correlated with increasing incidence of biliary gastritis. This finding is consistent with worldwide research, which revealed that caffeine causes gastric acid secretion, changes bile dynamics, and mucosal damage (24,25). Clinical states also showed significant correlations. Gallstones are significantly related to biliary gastritis, which is consistent with earlier studies (3,26), indicating that gallstones exacerbate biliary reflux, leading to gastric mucosal damage. Liver disease was also a significant predictor, as indicated by Alzubide and Bakkari (2025) (27), where dysfunctional liver function modified the composition and flow of bile to facilitate gastric mucosal exposure to cytotoxic bile acids. Surprisingly, in contrast to the results of Othman et al. (2021) (17), diabetes was not strongly associated with biliary gastritis in this study. This may be due to regional variations in diabetes control, genetic predispositions, or lifestyle patterns among Kurdish people (5). Nausea, vomiting, and abdominal pain are directly related to biliary gastritis, which is in line with other clinical evidence (9), and these symptoms are typical of bile-induced gastric irritation. Notably, heartburn and bloating are not directly related, as opposed to GERD-dominant groups (28). Patterns of healthcare access were also a significant finding. Annually or more frequently, visitors who saw medical care providers had greater rates of diagnosis. This may reflect greater disease awareness or greater chronic disease that led to visits to the physician, in line with Mahmood and Saleh's (2023) (8) models of healthcare disparities. Surgical type was also important: those with a history of gastric surgery had very high incidence rates of biliary gastritis in comparison to those with cholecystectomy alone. This finding aligns with the results of Chen et al. (2021) (16), who reported that surgical changes in the anatomy of the stomach may influence pyloric function, enhance duodenogastric reflux, and predispose patients to bile-induced mucosal damage. Relative to the international literature, several similarities can be observed, including the influence of diet, gallstones, and surgery. Some differences, most notably a lack of association with diabetes and alcohol consumption, imply strong cultural and environmental influences that need further investigation. Reduced alcohol consumption (29) and perhaps differences in diabetes control may account for these differences in Kurdistan. One of the strengths of this research is that it has a relatively large sample size (n = 638), and both urban and rural samples are included, which increases the external validity of the results in multiple contexts in Kurdistan. Applying a standard and previously validated measure (16,18) and direct verification from medical records to clinical histories also contributed to the methodological quality of the study. Nevertheless, several limitations need to be highlighted. The cross-sectional study design restricts the possibility of establishing causality between correlated variables and biliary gastritis. In addition, the use of self-reported food intake and symptoms can theoretically be associated with recall bias. Finally, restricted utilization of endoscopy and colonoscopy among participants has the potential for underestimating the true incidence of biliary gastritis. Additionally, genetic factors were not assessed, despite their recognized importance in previous studies (10,30). Conclusion This research highlights the high incidence of biliary gastritis among the adult population in the Kurdistan Region and highlights several primary factors, including sex, marital status, occupation, diet, gallstones, liver disease, and surgical history. The results provide suitable region-specific epidemiological findings for biliary gastritis and indicate the importance of early detection and prevention. According to these findings, community healthy eating initiatives, such as increased vegetable and fruit consumption and reduced fast food consumption, need to be enhanced. Physicians and healthcare providers need to be aware of the need to detect biliary gastritis in gallstone disease patients, liver disease patients, or postgastric surgery patients. Increasing the availability of diagnostic endoscopy services in rural areas could lead to early detection. Finally, future research should study the genetic predisposition to biliary gastritis among Kurds to formulate more detailed prevention and treatment schemes. Declarations Author Contributions Araz Omar Fatah : Conceptualization, study design, data analysis, and manuscript writing. Kochr Ali Mahmood : Literature review, data collection supervision, statistical interpretation, and manuscript editing. Saman Taher Barzinjy : Data collection, participant recruitment, and ethical approvals. Dilshad Hamad Mustafa Chomany : Methodology consultation, clinical data interpretation, and results validation. Dawan jamal hawezy: Wrote a part of introduction, as well as, organize the result section. Sirwan Khalid Ahmed : Review of gastrointestinal diagnostics, critical revision of the manuscript, and final approval. All authors read and approved the final manuscript. Acknowledgment We deeply thanks and appreciate all the participants from different regions and varies places in Kurdistan region-Iraq, to show their participation in the current study. As well as, many thanks for Faculty of General Medicine in Koya university to allow us and give us the ethical approval. Funding: The authors did not get any funding from anyone. Data availability : The data is available at the request to the corresponding author. Clinical trial number: not applicable. Ethical approval: Ethical approval for this study was granted by the Ethics Committee of the Faculty of Medicine, Koya University (Meeting Code: 19; Paper Code: 17). The study was carried out in accordance with the ethical standards of the institutional research committee and the principles of the Declaration of Helsinki. Inform consent: The participants provided oral informed consent before the data collection process began. References Huang G, Wang S, Wang J, Tian L, Yu Y, Zuo X, et al. 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Ahmed SK. How to choose a sampling technique and determine sample size for research: A simplified guide for researchers. Oral Oncol Rep. 2024 Dec;12:100662. Chen L, Zhu G, She L, Ding Y, Yang C, Zhu F. Analysis of Risk Factors and Establishment of a Prediction Model for Endoscopic Primary Bile Reflux: A Single-Center Retrospective Study. Front Med. 2021 Nov 10;8:758771. Othman AAA, Dwedar AAZ, ElSadek HM, AbdElAziz HR, Abdelrahman AAF. Bile reflux gastropathy: Prevalence and risk factors after therapeutic biliary interventions: A retrospective cohort study. Ann Med Surg. 2021 Dec 6;72:103168. Othman AA, Dwedar AA, ElSadek HM, AbdElAziz HR, Abdelrahman AA. Post-cholecystectomy bile reflux gastritis: Prevalence, risk factors, and clinical characteristics. Chronic Illn. 2023 Sep;19(3):529–38. Taşcı EK, Karakoyun M, Sezak M, Doğanavsargil B, Çetin F, Aydoğdu S. Does bile reflux reduce Helicobacter pylori gastritis? Turk J Pediatr. 2022 Feb 25;64(1):122–6. Mun E, Lee Y, Lee W, Park S. Cross-sectional association between long working hours and endoscopic gastritis: the Kangbuk Samsung Health Study. BMJ Open. 2021 Sep;11(9):e050037. Pang Y, Kartsonaki C, Guo Y, Chen Y, Yang L, Bian Z, et al. Socioeconomic Status in Relation to Risks of Major Gastrointestinal Cancers in Chinese Adults: A Prospective Study of 0.5 Million People. Cancer Epidemiol Biomarkers Prev. 2020 Apr 1;29(4):823–31. Peng Z, Wang R, Wu N, Gao H, Gao H, Li D. Assessment of the risk factors of duodenogastric reflux in relation to different dietary habits in a Chinese population of the Zhangjiakou area. Food Nutr Res [Internet]. 2023 Oct 24 [cited 2025 Apr 28];67. Available from: https://foodandnutritionresearch.net/index.php/fnr/article/view/9385 Morozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018 Jun 7;24(21):2291–9. Nehlig A. Effects of Coffee on the Gastro-Intestinal Tract: A Narrative Review and Literature Update. Nutrients. 2022 Jan 17;14(2):399. Taborska N, Martyka A, Kubicka Figiel M, Ujma P. The impact of consumed coffee on the digestive system - review of the latest research. J Educ Health Sport. 2024 Jan 14;53:32–43. Lim KPK, Lee AJL, Jiang X, Teng TZJ, Shelat VG. The link between Helicobacter pylori infection and gallbladder and biliary tract diseases: A review. Ann Hepato-Biliary-Pancreat Surg. 2023 Aug 31;27(3):241–50. Alzubide S, Bakkari S. Bile Reflux Gastritis: A Comprehensive Review. Open J Gastroenterol. 2025;15(02):35–50. Lee SW. Heartburn and regurgitation have different impacts on life quality of patients with gastroesophageal reflux disease. World J Gastroenterol. 2014;20(34):12277. Ali NSM, Allela OQ, Salih HM, Ahmed IH. Prevalence of Type 2 Diabetes Associated Complications Ion Kurdistan Region Iraq. J Basic Clin Pharma. 2018;9(2):262‑269. Wang C, Wang J, Fang M, Fei B. Genetic evidence causally linking gastroesophageal reflux disease to cholecystitis: a two-sample mendelian randomization study. BMC Gastroenterol. 2024 Sep 5;24(1):301. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6665067","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":482321535,"identity":"a28f41f2-068e-42cc-b709-609e2f6615fa","order_by":0,"name":"Araz Omar Fatah","email":"","orcid":"","institution":"Koya university","correspondingAuthor":false,"prefix":"","firstName":"Araz","middleName":"Omar","lastName":"Fatah","suffix":""},{"id":482321536,"identity":"afd8c64b-addf-452a-92f9-de2ae178e230","order_by":1,"name":"Kochr Ali Mahmood","email":"data:image/png;base64,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","orcid":"","institution":"Koya university","correspondingAuthor":true,"prefix":"","firstName":"Kochr","middleName":"Ali","lastName":"Mahmood","suffix":""},{"id":482321537,"identity":"e14ffc0b-56a8-4d4d-8a3a-ef611e528c33","order_by":2,"name":"Saman Taher Barzinjy","email":"","orcid":"","institution":"Koya university","correspondingAuthor":false,"prefix":"","firstName":"Saman","middleName":"Taher","lastName":"Barzinjy","suffix":""},{"id":482321538,"identity":"a875cdd6-d6cd-4436-8175-b3b3bb0fff76","order_by":3,"name":"Dilshad Hamad Mustafa","email":"","orcid":"","institution":"Hawler Medical University","correspondingAuthor":false,"prefix":"","firstName":"Dilshad","middleName":"Hamad","lastName":"Mustafa","suffix":""},{"id":482321539,"identity":"38a05d7a-f0d6-4f7b-8663-fdf26f91ab95","order_by":4,"name":"Dawan Jamal Hawezy","email":"","orcid":"","institution":"Koya university","correspondingAuthor":false,"prefix":"","firstName":"Dawan","middleName":"Jamal","lastName":"Hawezy","suffix":""},{"id":482321540,"identity":"9be14481-88b7-4c0b-9cd1-6f8157fa5127","order_by":5,"name":"Sirwan Khalid Ahmed","email":"","orcid":"","institution":"Knowledge University","correspondingAuthor":false,"prefix":"","firstName":"Sirwan","middleName":"Khalid","lastName":"Ahmed","suffix":""}],"badges":[],"createdAt":"2025-05-14 14:23:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6665067/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6665067/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86667917,"identity":"1ce6ab2e-fb33-46f5-8014-3546b2f19688","added_by":"auto","created_at":"2025-07-14 11:17:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":26437,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of biliary gastritis\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6665067/v1/8bc7288e2c5f3a1edc5c75c7.png"},{"id":86667919,"identity":"d31c01bc-c25b-4cb7-b2d8-a1921f67b2fc","added_by":"auto","created_at":"2025-07-14 11:17:12","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":109814,"visible":true,"origin":"","legend":"\u003cp\u003eAssociation between age and biliary gastritis\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6665067/v1/0ef70c599e65162e9afd1634.png"},{"id":90788380,"identity":"9df8cf4a-767f-4d55-86d6-387da574709a","added_by":"auto","created_at":"2025-09-08 07:53:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1149735,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6665067/v1/2564597d-7032-44a2-ae24-4698509615ed.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Incidence and Contributing Factors of Biliary Gastritis in the Kurdistan Region of Iraq","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBiliary gastritis is a serious and rare inflammatory disease of the gastric mucosa caused by bile reflux into the stomach, which, in most instances, is unnoticed compared with other gastrointestinal disorders. The global incidence of biliary gastritis is on the rise due to dietary transitions and an increase in obesity and gallbladder diseases (1,2).\u003c/p\u003e\u003cp\u003eThe pathophysiology of biliary gastritis involves impairment of the gastric mucosal barrier due to reflux of bile and duodenal contents. This reflux could be due to obstruction of the bile duct, complications of surgery such as cholecystectomy, or impaired gastric motility (3). These mechanisms suggest that the disease is multifactorial and call for a holistic approach to assessment, including lifestyle, genetic, and environmental considerations (4). The dietary pattern, which is unique to common gastrointestinal conditions such as gallstone diseases in the Kurdistan Region, provides a peculiar context for study (5).\u003c/p\u003e\u003cp\u003eWorldwide, high fat and low fiber contents are associated with biliary gastritis because of their roles in promoting bile stasis and sludge formation (6). In Kurdistan, traditional diets rich in animal fats, coupled with limited healthcare access and delayed diagnoses, may increase these risks (Ahmed et al., 2019). Additionally, urbanization and lifestyle shifts have fueled rising obesity and metabolic syndrome rates, further increasing the risk of biliary diseases (7).\u003c/p\u003e\u003cp\u003eIt is further exacerbated by disparities in healthcare: poor access to endoscopy and laboratory testing in rural Kurdistan leads to underdiagnosis and mismanagement (8). If left unattended, biliary gastritis may lead to severe complications such as peptic ulcers, gastric atrophy, and even gastric cancer (9).\u003c/p\u003e\u003cp\u003eThe other important factor is genetic predisposition. Variants in genes influencing bile salt metabolism have been associated with increased susceptibility to biliary gastritis (10). Only a few genetic studies have been performed in the Kurdish population, and this area has not been well explored. Genetic influences may provide insights into individual risk and interactions between genetic and environmental factors (11).\u003c/p\u003e\u003cp\u003eCultural practices and healthcare behaviors are both complicated in Kurdistan. Reliance on traditional remedies and delayed medical attention can worsen symptoms and further complicate treatment. Furthermore, infection with \u003cem\u003eHelicobacter pylori\u003c/em\u003e, a well-known risk factor for gastrointestinal diseases, may further complicate the understanding of biliary gastritis in this region (12,13).\u003c/p\u003e\u003cp\u003eAlthough research on biliary gastritis has expanded worldwide, few studies have focused on specific regions such as Kurdistan. Certainly, localized research becomes very important in this region because of dietary habits, genetic makeup, and healthcare structure (14).\u003c/p\u003e\u003cp\u003eThe present study, therefore, attempts to fill the gap in regional research with respect to its incidence and determining key contributing factors.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design and Setting\u003c/h2\u003e\u003cp\u003eThis research employed a descriptive cross-sectional study to determine the incidence and risk factors for biliary gastritis among the population in the Kurdistan Region. The researchers conducted the study between 21st June 2024 and 15th April 2025 in various health centers located in urban and rural areas to gather a representative sample.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe research focused on adults who were older than 18 years and who resided in both urban and rural areas of the Kurdistan Region. All participants who met the inclusion criteria and provided consent were included in the study, while those who had past gastric surgery and who refused consent were excluded.\u003c/p\u003e\n\u003ch3\u003eSample size and sampling technique\u003c/h3\u003e\n\u003cp\u003eA total of 638 participants were included in the research study. A multistage sampling technique was utilized. The researchers started by selecting major cities and rural areas before randomly choosing healthcare centers located in these areas. A simple random selection method was implemented to choose participants from each center to minimize selection bias (15).\u003c/p\u003e\n\u003ch3\u003eData collection tools and procedures\u003c/h3\u003e\n\u003cp\u003eA pretested standardized questionnaire was used to collect data through face‒to-face interviews with the participants. The questions were used in previous studies (16,17,3). The questionnaire contained two sections that examined demographic and lifestyle determinants together with eating habits and gastrointestinal symptoms as well as healthcare utilization and family medical history of gastric illness. Physical measurements such as height and weight were recorded to establish obesity status when needed. The assessment of the clinical history of patients with gallstone-related liver disease and diabetes and drug use was conducted through participant self-reports and medical records access when available.\u003c/p\u003e\u003cp\u003eThe research assessed both the dietary habits of participants regarding spicy and fast-food consumption along with their caffeine use patterns and their physical activity levels. Symptoms of gastritis were recorded, including nausea, vomiting, heartburn, bloating and abdominal pain. Endoscopic findings that included ulcers and erosions were documented in participants who underwent medical procedures.\u003c/p\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Prior to data collection, ethical approval was obtained from the Faculty of Medicine, Koya University, under reference number [meeting code 19; paper code17). All participants were informed about the purpose, procedures, potential risks, and benefits of the study, and oral informed consent was obtained from each participant. Confidentiality and anonymity were strictly maintained throughout the study. Participation was entirely voluntary, and participants were assured of their right to withdraw from the study at any time without any negative consequences.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eThe descriptive statistics, which included frequency distributions together with percentage means and standard deviations, were calculated. The relationships between biliary gastritis diagnosis and variables, including demographic traits, eating behaviors and comorbidities, were evaluated via chi-square tests together with logistic regression analysis when suitable. The results were considered significant at p\u0026thinsp;\u0026le;\u0026thinsp;0.05. The data analysis was conducted with SPSS version 27.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic and lifestyle factor distributions of the 638 participants are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The research study included 56.1% male participants and 43.9% female participants. Most research participants were married couples (78.4%), but 21.6% of the participants remained unmarried. The participants were divided into urban (52.4%) and rural (47.6%) residential areas. The employment status of the participants revealed that 52.7% worked, 44.5% did not work, and 2.8% were students. The sample data revealed that 69.3% of the participants did not smoke, whereas 30.7% of the participants were smokers. The survey results revealed that 95% of the participants did not consume alcohol, whereas 5% admitted to drinking alcohol. The survey results revealed that 73.4% of the participants did not exercise regularly, but 26.6% exercised one to two times per week. The sample participants had an average age of 43.53 years with a standard deviation of 15.25 years, which showed that the sample included participants of diverse ages.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFrequency and percentage distributions of demographic and lifestyle characteristics of the participants (N\u0026thinsp;=\u0026thinsp;638)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e358\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e500\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e78.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e334\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e304\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccupation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e336\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e52.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e284\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e442\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e69.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlcohol Use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e606\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysical Activity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e73.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 times/week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean of age\u0026thinsp;\u0026plusmn;\u0026thinsp;S.D\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.53\u0026thinsp;\u0026plusmn;\u0026thinsp;15.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe eating patterns of the research participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The study population revealed that 62.7% never ate spicy foods, but 37.3% ate them at times. The population distribution regarding fast food consumption revealed that 64.9% did not eat fast food, whereas 35.1% did. Most participants (57.7%) reported eating fruit and vegetables infrequently, but 30.1% consumed them weekly, 10% ate them three to four times per week, and only 2.2% ate them daily. The survey results revealed that 53.3% of the participants consumed caffeine rarely, 42.3% consumed it occasionally, and 4.4% reported daily caffeine consumption.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFrequency and percentage distributions of dietary habits among participants (N\u0026thinsp;=\u0026thinsp;638)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpicy Food Consumption\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e238\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e37.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFast Food Consumption\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e414\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e224\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFruit and Vegetable Intake\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e368\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely/Once a Week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;4 Times per Week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDaily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCaffeine Intake\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e340\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e53.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOccasionally\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e270\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 Times per Day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe incidence rates of gastrointestinal and related medical conditions in the participants are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Most (90.6%) did not have gastroesophageal reflux disease (GERD), and 9.4% had been diagnosed with GERD. Peptic ulcer disease was observed in 45.1% of the participants, but 54.9% did not have it. Among the gallstones, 26.6% of the participants had gallstones, and 73.4% had none. Similarly, 11.6% of the respondents had liver disease, whereas 88.4% did not have liver disease. In the context of diabetes, 7.2% of the participants reported that they were diabetic, whereas 92.8% reported that they were not diabetic. With respect to medication use, 64.6% of the respondents were currently on medication, whereas 35.4% were not on medication.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of gastrointestinal conditions among participants (N\u0026thinsp;=\u0026thinsp;638)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGastroesophageal Reflux Disease (GERD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e578\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e90.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePeptic Ulcer Disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e350\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e54.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e288\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e45.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGallstones\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e73.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e26.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiver Disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e564\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e88.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e592\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e92.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTaking medication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e226\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e35.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e412\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e64.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe data presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e demonstrate the occurrence of gastritis symptoms among the research participants. The survey results revealed that 15.7% of the participants experienced vomiting and nausea, but 84.3% of the participants did not experience these symptoms. Heartburn symptoms were documented by 18.2% of the participants, but 81.8% of the participants did not experience heartburn. Stomach pain symptoms appeared frequently among the participants because 41.1% of them reported it, but 58.9% of the participants did not experience this symptom. The survey results indicated that bloating symptoms were reported by 15% of the participants, but 85% of the participants did not experience bloating. The survey revealed that 10% of the participants experienced loss of appetite, but 90% of the participants did not. The participants experienced symptoms for three different time periods, with 48.3% reporting less than one month of symptoms and 38.9% reporting symptoms between one and six months and 12.9% reporting symptoms from six months to one year.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Symptoms Related to Gastritis (N\u0026thinsp;=\u0026thinsp;638)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNausea and Vomiting\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e538\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeartburn\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e522\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStomach Pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e376\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e58.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e262\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBloating\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e542\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLoss of Appetite\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e574\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of Symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1 Month\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e308\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;6 Months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e248\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6 Months \u0026ndash; 1 Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe incidence of biliary gastritis among the participants in the study is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The total number of participants was 486, 73.3% (n\u0026thinsp;=\u0026thinsp;356) of whom did not have biliary gastritis, while 26.7% (n\u0026thinsp;=\u0026thinsp;130) of them had biliary gastritis. This means that although most participants did not have biliary gastritis, a significant proportion above a quarter were affected. These findings highlight the high incidence of biliary gastritis in the study population and the importance of early diagnosis and appropriate treatment protocols since the disease has complications.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe data in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e show how often respondents visited healthcare providers and underwent diagnostic tests and endoscopic procedures. The data revealed that 51.4% of the participants visited healthcare providers annually, 37.9% visited them infrequently, 7.8% visited them twice or thrice annually, and only 2.8% visited them more than three times annually. The majority of participants (85.6%) had never received endoscopy or colonoscopy procedures, but 14.4% had actually undergone these tests. The study revealed that 24.5% of the participants had gastric disease in their families, but 75.5% did not have such a history. The study revealed that 38.2% of the participants had experienced melena (dark stool) symptoms in the past, but 61.8% did not have this symptom. The endoscopy results revealed that ulcers were present in 16% of the participants, but 84% had no ulcer findings. The examination revealed gastric erosion in 22.6% of the participants, but 77.4% showed no signs of erosion.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Healthcare Visits, Diagnostic Testing, and Endoscopic Findings among the Participants (N\u0026thinsp;=\u0026thinsp;638)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercent (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFrequency of GI Healthcare Visits\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e242\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e37.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOnce a Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e328\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;3 Times per Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore Than 3 Times per Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHistory of Endoscopy/Colonoscopy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e546\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily History of Gastric Disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e482\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHistory of Melena (Dark Stool)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e394\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e244\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUlcer Findings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e536\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eErosion Findings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e494\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e77.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe analysis presented in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e demonstrates how various demographic elements, together with lifestyle factors, influence biliary gastritis diagnosis among study participants. The female population had a higher biliary gastritis diagnosis rate (32.9%) than the male population did (22.7%) according to the statistical analysis (p\u0026thinsp;=\u0026thinsp;0.004). The marital status of the respondents was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) because married individuals (p\u0026thinsp;=\u0026thinsp;32.1) received fewer biliary gastritis diagnoses than unmarried participants did (p\u0026thinsp;=\u0026thinsp;10.1%). The appropriate process: The diagnosis of biliary gastritis did not significantly differ between urban and rural residents (p\u0026thinsp;=\u0026thinsp;0.367). Occupation status was significantly related to biliary gastritis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) because unemployed patients developed this condition at a rate of 37.3%, whereas working patients developed it at a rate of 19.9%. The students presented unexpected findings because they had no recorded cases of biliary gastritis. The analysis revealed a strong link between smoking history and biliary gastritis diagnosis (p\u0026thinsp;=\u0026thinsp;0.001), with nonsmokers showing a higher rate (31.2%) than smokers (17.6%). The correlation between alcohol consumption and biliary gastritis diagnosis was extremely high (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) because no biliary gastritis cases occurred among drinkers, but 28.7% of nondrinkers developed this condition. Physical exercise was weakly related to biliary gastritis (p\u0026thinsp;=\u0026thinsp;0.949) because the exercise and nonexercise groups presented similar rates.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between Demographic and Lifestyle Variables and Diagnosed Biliary Gastritis (N\u0026thinsp;=\u0026thinsp;624)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiagnosed No (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDiagnosed Yes (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e266 (77.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e78 (22.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e188 (67.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92 (32.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124 (89.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (10.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e330 (67.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e156 (32.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResidence\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e238 (71.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e96 (28.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.367\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRural\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e216 (74.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e74 (25.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccupation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e258 (80.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e64 (19.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e178 (62.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e106 (37.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e304 (68.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e138 (31.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e150 (82.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32 (17.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlcohol Use\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e422 (71.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e170 (28.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePhysical Activity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e330 (72.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e124 (27.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.949\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2/week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124 (72.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46 (27.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e shows the relationships between food habits, biliary gastritis, clinical parameters, and the diagnosis of biliary gastritis in the participants. The consumption of spicy food was not significantly correlated with biliary gastritis (p\u0026thinsp;=\u0026thinsp;0.370), whereas the consumption of fast food was significantly correlated with biliary gastritis (p\u0026thinsp;=\u0026thinsp;0.005), with fewer cases of biliary gastritis among fast food consumers. Fruit consumption was strongly correlated (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) with the highest number of participants with biliary gastritis who ate fruit three to four times a week.\u003c/p\u003e\u003cp\u003eCaffeine consumption was also significantly correlated with biliary gastritis (p\u0026thinsp;=\u0026thinsp;0.010), and an increased incidence was noted in participants who ate caffeine one to two times a day. Gastroesophageal reflux disease (GERD), diabetes, peptic ulcer disease, heartburn, bloating, loss of appetite, and family history of gastric disease were not significantly correlated with biliary gastritis (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Gallstones (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), the intake of medications (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and liver disease (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly correlated with increased diagnostic rates of biliary gastritis.\u003c/p\u003e\u003cp\u003eFurthermore, nausea and vomiting were strongly correlated with biliary gastritis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), in which half of the patients who experienced these symptoms had the disease. Pain in the abdomen was also highly correlated (p\u0026thinsp;=\u0026thinsp;0.038), with higher frequencies in those without pain. The number of patients who visited healthcare facilities was also highly correlated with the number of patients with a diagnosis of biliary gastritis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with those who visited healthcare facilities once a year or more having higher frequencies. Finally, the nature of surgery was significantly related (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) to a much greater incidence of biliary gastritis in postgastric surgery patients than in cholecystectomy patients.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation between Dietary Habits, Clinical Factors, and Diagnosed Biliary Gastritis (N\u0026thinsp;=\u0026thinsp;624)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiagnosed No (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDiagnosed Yes (n, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eSpicy food\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e276 (71.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e110 (28.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.370\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e178 (74.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60 (25.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eFast food\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e276 (69.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e124 (31.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e178 (79.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46 (20.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eFruit intake\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e248 (70.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106 (29.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce a Week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e160 (83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (16.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u0026ndash;4 Times a Week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDaily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eCaffeine Intake\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e234 (71.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92 (28.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccasionally\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e206 (76.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64 (23.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u0026ndash;2 Times a Day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eGastroesophageal Reflux Disease\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e408 (72.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e156 (27.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.474\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46 (76.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (23.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003ePeptic Ulcer Disease\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e248 (73.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e88 (26.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.523\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e206 (71.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82 (28.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGallstone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e312 (68.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (31.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e142 (83.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28 (16.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eLiver Disease\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e426 (75.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e138 (24.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28 (46.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (53.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eDiabetes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e422 (73.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e156 (27.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.613\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (69.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (30.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eUsing medication\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e198 (93.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (6.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e256 (62.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e156 (37.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eNausea and Vomiting\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e404 (77.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e120 (22.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50 (50.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eHeartburn\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e370 (72.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e138 (27.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.927\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84 (72.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32 (27.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eStomach Pain\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e252 (69.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e110 (30.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e202 (77.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60 (22.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eBloating\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e386 (73.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (26.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.645\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e68 (70.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28 (29.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eLoss of Appetite\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e404 (72.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e156 (27.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.309\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50 (78.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (21.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eFamily History of Gastric Disease\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e344 (73.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e124 (26.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.467\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e110 (70.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46 (29.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eFrequency of GI Healthcare Visits\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e224 (92.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (7.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce a Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e180 (57.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e134 (42.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u0026ndash;3 Times/Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (64.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (36.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than 3/Year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 (100.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003eType of Surgery\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCholecystectomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e362 (79.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e92 (20.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGastric Surgery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e92 (54.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78 (45.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eGraph 2 shows the age distribution of the participants according to their diagnosis of biliary gastritis via the independent-samples Mann‒Whitney U test. The mean rank for the nondiagnosed participants was 304.31, and that of the diagnosed participants was 334.36. The p value was 0.063. This implies that age could have a small, although not statistically significant, effect on the probability of being diagnosed with biliary gastritis among this population.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aim of this research was to identify the incidence and risk factors for biliary gastritis in the population of adults residing in the Kurdistan Region. The incidence rate of biliary gastritis among the subjects was high at 26.7%, which aligns with the rising world trend of disease incidence (18,19). This highlights the need for region-specific epidemiological information, with particular attention given to the common diet, shortages in healthcare access, and culture of the Kurdistan Region.\u003c/p\u003e\u003cp\u003eThe strongest finding was the strong association of female sex with biliary gastritis, with females having a greater likelihood of being diagnosed than males. This result is consistent with that of Livzan et al. (2023)(3), in which greater biliary reflux and gastritis secondary to the disease were observed in women, perhaps because of hormonal regulation of bile chemistry and gastric motility. Marital status was also associated with the disease, with a greater proportion among married subjects. Marital status, although less frequently noted in earlier literature, can be seen as an indirect marker of lifestyle and stress factors affecting gastrointestinal disease.\u003c/p\u003e\u003cp\u003eThe relationship between unemployment and high rates of biliary gastritis in this study conflicts with the findings of Mun et al. (2021) (20), who reported a higher prevalence of biliary gastritis among people who work 55 hours a week. A low socioeconomic status is associated with a poor diet, delayed entry into the health system, and a higher incidence of gastrointestinal disease (21). These findings indicate the socioeconomic aspect of disparity in the incidence of biliary gastritis.\u003c/p\u003e\u003cp\u003eIn terms of diet, fast food consumption was significantly related to biliary gastritis risk. This finding is supported by the studies of Peng et al. (2023) (22), who reported that a high-fat and low-fiber diet leads to bile stasis, delayed gastric emptying, and increased mucosal damage. Consistent with this, the consumption of fruits and vegetables was protective; individuals who consumed fruits and vegetables frequently, particularly three to four times a week, had a reduced incidence of biliary gastritis. This result aligns with that of a previous study, which reported that a diet rich in fibers is involved in defense against bile flow and duodenogastric reflux (23).\u003c/p\u003e\u003cp\u003eThe consumption of caffeine presented a statistically significant correlation, and increasing daily consumption correlated with increasing incidence of biliary gastritis. This finding is consistent with worldwide research, which revealed that caffeine causes gastric acid secretion, changes bile dynamics, and mucosal damage (24,25).\u003c/p\u003e\u003cp\u003eClinical states also showed significant correlations. Gallstones are significantly related to biliary gastritis, which is consistent with earlier studies (3,26), indicating that gallstones exacerbate biliary reflux, leading to gastric mucosal damage. Liver disease was also a significant predictor, as indicated by Alzubide and Bakkari (2025) (27), where dysfunctional liver function modified the composition and flow of bile to facilitate gastric mucosal exposure to cytotoxic bile acids.\u003c/p\u003e\u003cp\u003eSurprisingly, in contrast to the results of Othman et al. (2021) (17), diabetes was not strongly associated with biliary gastritis in this study. This may be due to regional variations in diabetes control, genetic predispositions, or lifestyle patterns among Kurdish people (5).\u003c/p\u003e\u003cp\u003eNausea, vomiting, and abdominal pain are directly related to biliary gastritis, which is in line with other clinical evidence (9), and these symptoms are typical of bile-induced gastric irritation. Notably, heartburn and bloating are not directly related, as opposed to GERD-dominant groups (28).\u003c/p\u003e\u003cp\u003ePatterns of healthcare access were also a significant finding. Annually or more frequently, visitors who saw medical care providers had greater rates of diagnosis. This may reflect greater disease awareness or greater chronic disease that led to visits to the physician, in line with Mahmood and Saleh's (2023) (8) models of healthcare disparities.\u003c/p\u003e\u003cp\u003eSurgical type was also important: those with a history of gastric surgery had very high incidence rates of biliary gastritis in comparison to those with cholecystectomy alone. This finding aligns with the results of Chen et al. (2021) (16), who reported that surgical changes in the anatomy of the stomach may influence pyloric function, enhance duodenogastric reflux, and predispose patients to bile-induced mucosal damage.\u003c/p\u003e\u003cp\u003eRelative to the international literature, several similarities can be observed, including the influence of diet, gallstones, and surgery. Some differences, most notably a lack of association with diabetes and alcohol consumption, imply strong cultural and environmental influences that need further investigation. Reduced alcohol consumption (29) and perhaps differences in diabetes control may account for these differences in Kurdistan.\u003c/p\u003e\u003cp\u003eOne of the strengths of this research is that it has a relatively large sample size (n\u0026thinsp;=\u0026thinsp;638), and both urban and rural samples are included, which increases the external validity of the results in multiple contexts in Kurdistan. Applying a standard and previously validated measure (16,18) and direct verification from medical records to clinical histories also contributed to the methodological quality of the study.\u003c/p\u003e\u003cp\u003eNevertheless, several limitations need to be highlighted. The cross-sectional study design restricts the possibility of establishing causality between correlated variables and biliary gastritis. In addition, the use of self-reported food intake and symptoms can theoretically be associated with recall bias. Finally, restricted utilization of endoscopy and colonoscopy among participants has the potential for underestimating the true incidence of biliary gastritis. Additionally, genetic factors were not assessed, despite their recognized importance in previous studies (10,30).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis research highlights the high incidence of biliary gastritis among the adult population in the Kurdistan Region and highlights several primary factors, including sex, marital status, occupation, diet, gallstones, liver disease, and surgical history. The results provide suitable region-specific epidemiological findings for biliary gastritis and indicate the importance of early detection and prevention. According to these findings, community healthy eating initiatives, such as increased vegetable and fruit consumption and reduced fast food consumption, need to be enhanced. Physicians and healthcare providers need to be aware of the need to detect biliary gastritis in gallstone disease patients, liver disease patients, or postgastric surgery patients. Increasing the availability of diagnostic endoscopy services in rural areas could lead to early detection. Finally, future research should study the genetic predisposition to biliary gastritis among Kurds to formulate more detailed prevention and treatment schemes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAraz Omar Fatah\u003c/strong\u003e: Conceptualization, study design, data analysis, and manuscript writing.\u003cbr\u003e\u003cstrong\u003eKochr Ali Mahmood\u003c/strong\u003e: Literature review, data collection supervision, statistical interpretation, and manuscript editing.\u003cbr\u003e\u003cstrong\u003eSaman Taher Barzinjy\u003c/strong\u003e: Data collection, participant recruitment, and ethical approvals.\u003cbr\u003e\u003cstrong\u003eDilshad Hamad Mustafa Chomany\u003c/strong\u003e: Methodology consultation, clinical data interpretation, and results validation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDawan jamal hawezy:\u0026nbsp;\u003c/strong\u003e Wrote a part of introduction, as well as, organize the result section.\u0026nbsp;\u003cbr\u003e\u003cstrong\u003eSirwan Khalid Ahmed\u003c/strong\u003e: Review of gastrointestinal diagnostics, critical revision of the manuscript, and final approval.\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe deeply thanks and appreciate all the participants from different regions and varies places in Kurdistan region-Iraq, to show their participation in the current study. As well as, many thanks for Faculty of General Medicine in Koya university to allow us and give us the ethical approval.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe authors did not get any funding from anyone.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e: The data is available at the request to the corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval:\u0026nbsp;\u003c/strong\u003eEthical approval for this study was granted by the Ethics Committee of the Faculty of Medicine, Koya University (Meeting Code: 19; Paper Code: 17). The study was carried out in accordance with the ethical standards of the institutional research committee and the principles of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInform consent:\u0026nbsp;\u003c/strong\u003eThe participants provided oral informed consent before the data collection process began.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHuang G, Wang S, Wang J, Tian L, Yu Y, Zuo X, et al. Bile reflux alters the profile of the gastric mucosa microbiota. Front Cell Infect Microbiol. 2022 Sep 9;12:940687. \u003c/li\u003e\n\u003cli\u003eShi X, Chen Z, Yang Y, Yan S. Bile Reflux Gastritis: Insights into Pathogenesis, Relevant Factors, Carcinomatous Risk, Diagnosis, and Management. Toyokawa T, editor. Gastroenterol Res Pract. 2022 Sep 12;2022:1\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eLivzan MA, Mozgovoi SI, Gaus OV, Bordin DS, Kononov AV. 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Prevalence and determinants of tobacco use among Iraqi adolescents: Iraq GYTS 2012. Tob Induc Dis. 2013;11(1):14. \u003c/li\u003e\n\u003cli\u003eSaeed AY, Rashad BH, Ali BN, Sulaivany AH, Ibrahim KS. Helicobacter pylori Infection: Prevalence, Risk Factors, and Treatment Efficacy in Symptomatic Patients in Zakho City, Kurdistan Region, Iraq. Cureus [Internet]. 2024 Nov 17 [cited 2024 Nov 19]; Available from: https://www.cureus.com/articles/263572-helicobacter-pylori-infection-prevalence-risk-factors-and-treatment-efficacy-in-symptomatic-patients-in-zakho-city-kurdistan-region-iraq\u003c/li\u003e\n\u003cli\u003eSalaim T, Balaky S, Al-Rawi R, Abdulla S, Mawlood A, Jawhar N, et al. Clinical manifestation of Helicobacter pylori infection and its association with gastric adenocarcinoma in gastritis patients in Erbil, Kurdistan Region, Iraq. Zanco J Med Sci. 2022 Aug 25;26(2):178\u0026ndash;84. \u003c/li\u003e\n\u003cli\u003eAhmed SK. How to choose a sampling technique and determine sample size for research: A simplified guide for researchers. Oral Oncol Rep. 2024 Dec;12:100662. \u003c/li\u003e\n\u003cli\u003eChen L, Zhu G, She L, Ding Y, Yang C, Zhu F. Analysis of Risk Factors and Establishment of a Prediction Model for Endoscopic Primary Bile Reflux: A Single-Center Retrospective Study. Front Med. 2021 Nov 10;8:758771. \u003c/li\u003e\n\u003cli\u003eOthman AAA, Dwedar AAZ, ElSadek HM, AbdElAziz HR, Abdelrahman AAF. Bile reflux gastropathy: Prevalence and risk factors after therapeutic biliary interventions: A retrospective cohort study. Ann Med Surg. 2021 Dec 6;72:103168. \u003c/li\u003e\n\u003cli\u003eOthman AA, Dwedar AA, ElSadek HM, AbdElAziz HR, Abdelrahman AA. Post-cholecystectomy bile reflux gastritis: Prevalence, risk factors, and clinical characteristics. Chronic Illn. 2023 Sep;19(3):529\u0026ndash;38. \u003c/li\u003e\n\u003cli\u003eTaşcı EK, Karakoyun M, Sezak M, Doğanavsargil B, \u0026Ccedil;etin F, Aydoğdu S. Does bile reflux reduce Helicobacter pylori gastritis? Turk J Pediatr. 2022 Feb 25;64(1):122\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eMun E, Lee Y, Lee W, Park S. Cross-sectional association between long working hours and endoscopic gastritis: the Kangbuk Samsung Health Study. BMJ Open. 2021 Sep;11(9):e050037. \u003c/li\u003e\n\u003cli\u003ePang Y, Kartsonaki C, Guo Y, Chen Y, Yang L, Bian Z, et al. Socioeconomic Status in Relation to Risks of Major Gastrointestinal Cancers in Chinese Adults: A Prospective Study of 0.5 Million People. Cancer Epidemiol Biomarkers Prev. 2020 Apr 1;29(4):823\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003ePeng Z, Wang R, Wu N, Gao H, Gao H, Li D. Assessment of the risk factors of duodenogastric reflux in relation to different dietary habits in a Chinese population of the Zhangjiakou area. Food Nutr Res [Internet]. 2023 Oct 24 [cited 2025 Apr 28];67. Available from: https://foodandnutritionresearch.net/index.php/fnr/article/view/9385\u003c/li\u003e\n\u003cli\u003eMorozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018 Jun 7;24(21):2291\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eNehlig A. Effects of Coffee on the Gastro-Intestinal Tract: A Narrative Review and Literature Update. Nutrients. 2022 Jan 17;14(2):399. \u003c/li\u003e\n\u003cli\u003eTaborska N, Martyka A, Kubicka Figiel M, Ujma P. The impact of consumed coffee on the digestive system - review of the latest research. J Educ Health Sport. 2024 Jan 14;53:32\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eLim KPK, Lee AJL, Jiang X, Teng TZJ, Shelat VG. The link between \u003cem\u003eHelicobacter pylori\u003c/em\u003e infection and gallbladder and biliary tract diseases: A review. Ann Hepato-Biliary-Pancreat Surg. 2023 Aug 31;27(3):241\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eAlzubide S, Bakkari S. Bile Reflux Gastritis: A Comprehensive Review. Open J Gastroenterol. 2025;15(02):35\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eLee SW. Heartburn and regurgitation have different impacts on life quality of patients with gastroesophageal reflux disease. World J Gastroenterol. 2014;20(34):12277. \u003c/li\u003e\n\u003cli\u003eAli NSM, Allela OQ, Salih HM, Ahmed IH. Prevalence of Type 2 Diabetes Associated Complications Ion Kurdistan Region Iraq. J Basic Clin Pharma. 2018;9(2):262‑269. \u003c/li\u003e\n\u003cli\u003eWang C, Wang J, Fang M, Fei B. Genetic evidence causally linking gastroesophageal reflux disease to cholecystitis: a two-sample mendelian randomization study. BMC Gastroenterol. 2024 Sep 5;24(1):301. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Biliary gastritis, bile reflux, food factors, gallstones, Kurdistan, gastrointestinal well-being","lastPublishedDoi":"10.21203/rs.3.rs-6665067/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6665067/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and objective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBiliary gastritis is a neglected inflammatory disorder caused by bile reflux with a growing incidence worldwide due to lifestyle and dietetic modifications. Regional data are scarce for the Kurdistan Region. To identify the incidence of biliary gastritis and related demographic, lifestyle, dietetic, and clinical factors in the Kurdistan Region among adults.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive cross-sectional study was carried out among 638 adults who were recruited from urban and rural health centers. Data were gathered through structured interviews, medical record review, and clinical examination. Chi-square tests and logistic regression were applied to identify associations between biliary gastritis and different factors, and p ≤ 0.05 was considered significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe incidence of biliary gastritis was 26.7%. Strong correlations existed with female sex, marriage status, nonemployment status, regular use of fast food, low consumption of fruit, consumption of caffeine, gallstones, liver disease, drug abuse, and symptoms of nausea and abdominal pain (p \u0026lt; 0.05). A strong correlation did not exist with diabetes, GERD, or exercise. Patients with ahistory of gastric surgery also had a higher incidence of biliary gastritis. The average age did not differ between the diagnosed and undiagnosed patients (p = 0.063).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBiliary gastritis is a relevant public health issue in the Kurdistan Region that depends on food consumption habits, comorbidities, and economics. Healthier nutritional interventions should be combined with improved diagnostic access.\u003c/p\u003e","manuscriptTitle":"Incidence and Contributing Factors of Biliary Gastritis in the Kurdistan Region of Iraq","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-14 11:17:08","doi":"10.21203/rs.3.rs-6665067/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9faa9986-46d4-44d6-b464-933c3a37befb","owner":[],"postedDate":"July 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-08T07:53:24+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-14 11:17:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6665067","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6665067","identity":"rs-6665067","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}