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Changes in prevalence, incidence and spontaneous loss of gastro-oesophageal reflux symptoms: a prospective population-based cohort study, the HUNT study
  1. Eivind Ness-Jensen1,2,
  2. Anna Lindam3,
  3. Jesper Lagergren3,4,
  4. Kristian Hveem1
  1. 1HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
  2. 2Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
  3. 3Upper Gastrointestinal Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  4. 4Division of Cancer Studies, King's College London, United Kingdom
  1. Correspondence to Eivind Ness-Jensen, HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsvegen 2, Levanger N-7600, Norway; eivind.ness-jensen{at}


Objective Changes in the occurrence of gastro-oesophageal reflux symptoms (GORS) in the population remain uncertain. This study aimed to determine the prevalence changes, the incidence and the spontaneous loss of GORS.

Design This population-based cohort study was conducted within the Nord-Trøndelag Health Study (the HUNT study), a longitudinal series of population-based health surveys in Nord-Trøndelag County, Norway. The study base encompassed all adult residents in the county, and the participants reported the degree of GORS during the previous 12 months. The number of participants included were 58 869 (64% response rate) in 1995–7 and 44 997 (49%) in 2006–9. Of these, 29 610 persons (61%) were prospectively followed up for an average of 11 years.

Results Between 1995–7 and 2006–9, the prevalence of any, severe and at least weekly GORS increased by 30% (from 31.4% to 40.9%), 24% (from 5.4% to 6.7%) and 47% (from 11.6% to 17.1%), respectively. The average annual incidence of any and severe GORS was 3.07% and 0.23%, respectively. In women, but not men, the incidence of GORS increased with increasing age. The average annual spontaneous loss (not due to antireflux medication) of any and severe GORS was 2.32% and 1.22%, respectively. The spontaneous loss of GORS decreased with increasing age.

Conclusion Between 1995–7 and 2006–9 the prevalence of GORS increased substantially. At least weekly GORS increased by 47%. The average annual incidence of severe GORS was 0.23%, and the corresponding spontaneous loss was 1.22%. The incidence and spontaneous loss of GORS were influenced by sex and age.

  • Adenocarcinoma
  • epidemiology
  • gastroesophageal reflux disease
  • oesophageal reflux
  • oesophageal surgery

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  • Funding EN-J has received a PhD grant from the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology. AL and JL are supported by the Swedish Research Council. The funding sources had no involvement in the study design; collection, analysis, or interpretation of data, writing the paper or the decision to submit the paper for publication. The HUNT study is performed through collaboration between the HUNT Research Centre (Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology), Nord-Trøndelag County Council and the Norwegian Institute of Public Health.

  • Competing interests None.

  • Ethics approval As a result of the large number of participants in the HUNT study (58 869 and 44 997 participants in HUNT 2 and HUNT 3/Mini-Q, respectively) and the long time span of the study (from 1995), it would be an extremely demanding task to contact each participant, guardian or next of kin to gather a signed BMJ patient consent form. However, the study was approved by the Regional Committee for Medical and Health Research Ethics, Central Norway, and all participants signed a written consent form when they participated in the HUNT study, which stated that the data collected could be linked with health registries and patient records for research purposes in future studies. This is also stated in the manuscript. There is no information in the manuscript that could identify any participant.

  • Provenance and peer review Not commissioned; externally peer reviewed.