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Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review
  1. Hashem B El-Serag1,
  2. Stephen Sweet2,
  3. Christopher C Winchester2,3,
  4. John Dent4
  1. 1Section of Gastroenterology and Hepatology, Houston Veterans Affairs Medical Center (152), Houston, Texas, USA
  2. 2Research Evaluation Unit, Oxford PharmaGenesis, Oxford, UK
  3. 3Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK
  4. 4Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
  1. Correspondence to Dr Hashem B El-Serag, Section of Gastroenterology and Hepatology, Houston VA Medical Center, and Baylor College of Medicine, 2002 Holcombe Boulevard (152), Houston, TX 77030, USA; hasheme{at}


Objective To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD).

Design PubMed and Embase were screened for new references using the original search strings. Studies were required to be population-based, to include ≥200 individuals, to have response rates ≥50% and recall periods <12 months. GERD was defined as heartburn and/or regurgitation on at least 1 day a week, or according to the Montreal definition, or diagnosed by a clinician. Temporal and geographic trends in disease prevalence were examined using a Poisson regression model.

Results 16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%–27.8% in North America, 8.8%–25.9% in Europe, 2.5%–7.8% in East Asia, 8.7%–33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 1–17 years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p<0.0001), particularly in North America and East Asia.

Conclusions GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.

  • Gastroesophageal Reflux Disease
  • Epidemiology

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