Prevalence and Risk Factors of Gastroesophageal Reflux Disease Among University Students in Saudi Arabia: A Systematic Review and Meta-Analysis of Studies Up to 2025.

Gastroesophageal reflux disease (GERD) is increasingly reported among young adults, yet its burden in university populations within Saudi Arabia has not been fully characterized. This systematic review and meta-analysis assessed the prevalence of GERD and its associated risk factors among university students in Saudi Arabia. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar was conducted from inception to October 2025. Eligible studies were observational, conducted among university or college students in Saudi Arabia, and used validated diagnostic methods such as the GERD Questionnaire (GerdQ) with a cutoff score of ≥8. Eight studies involving 7,229 students met the inclusion criteria. Study characteristics, prevalence estimates, and associated risk factors were extracted, and study quality was assessed using the Newcastle-Ottawa Scale, with most studies demonstrating high methodological quality (scores 7-9). Meta-analysis was performed using random-effects models with logit transformation. The pooled prevalence of GERD was 26% (95%CI: 21-31%), with individual study estimates ranging from 18% to 35%. Subgroup analyses showed comparable prevalence estimates among female participants (24.97%), male participants (25.50%), medical students (29.30%), and non-medical or mixed student populations (25.43%), with no statistically significant differences between subgroups. Between-study heterogeneity was substantial (I² = 93.3%). Reported risk factors included smoking, high body mass index, tea or coffee consumption, fast food intake, psychological stress, and positive family history, while regular physical activity and higher fiber intake appeared protective. These findings indicate a substantial burden of GERD among university students in Saudi Arabia and highlight the need for targeted prevention and health promotion strategies in this population.