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Gut 54:710-717 doi:10.1136/gut.2004.051821
  • Recent advances in basic science

Epidemiology of gastro-oesophageal reflux disease: a systematic review

  1. J Dent1,
  2. H B El-Serag2,
  3. M-A Wallander3,
  4. S Johansson3
  1. 1Department of Gastroenterology, Hepatology, and General Medicine, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
  2. 2Section of Gastroenterology, Houston Veterans Affairs Medical Center (152), Houston, Texas, USA
  3. 3AstraZeneca R&D Mölndal, SE-43183, Sweden
  1. Correspondence to:
    Professor J Dent
    Department of Gastroenterology, Hepatology, and General Medicine, Level 7, North Wing, North Terrace, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; jdentmail.rah.sa.gov.au

    SUMMARY

    A systematic review of the epidemiology of gastro-oesophageal reflux disease (GORD) has been performed, applying strict criteria for quality of studies and the disease definition used. The prevalence and incidence of GORD was estimated from 15 studies which defined GORD as at least weekly heartburn and/or acid regurgitation and met criteria concerning sample size, response rate, and recall period. Data on factors associated with GORD were also evaluated.

    An approximate prevalence of 10–20% was identified for GORD, defined by at least weekly heartburn and/or acid regurgitation in the Western world while in Asia this was lower, at less than 5%. The incidence in the Western world was approximately 5 per 1000 person years. A number of potential risk factors (for example, an immediate family history and obesity) and comorbidities (for example, respiratory diseases and chest pain) associated with GORD were identified.

    Data reported in this systematic review can be interpreted with confidence as reflecting the epidemiology of “true” GORD. The disease is more common in the Western world than in Asia, and the low rate of incidence relative to prevalence reflects its chronicity. The small number of studies eligible for inclusion in this review highlights the need for global consensus on a symptom based definition of GORD.

    INTRODUCTION

    The study of the epidemiology of GORD is restricted by the lack of consensus over the basic definition of the disease. To review the global epidemiology of GORD is currently problematic as there is no internationally applied definition, although the need for this has been recognised.1 Gastro-oesophageal reflux manifests as a continuum of symptom frequency and/or severity in the general population. Occasional symptoms are experienced by a large proportion of the population but GORD results from frequent or severe symptoms which are sufficient to impair the individual’s health related quality of life …