Systematic review on epidemiology of gastroesophageal reflux disease in Asia

Background & Aims: The epidemiology of gastroesophageal reflux disease (GERD) has been a subject of much interest in recent years. This review ascertains the prevalence of GERD in eastern and southeastern Asia, and reports on complications and risk factors. Methods: This qualitative systematic review of the epidemiology of GERD in eastern and southeastern Asia identified studies in adults reported in English in the Medline database (searched through April 2005), relevant reviews, and our own bibliographic databases. Results: Thirteen studies were included. The reported population prevalence of GERD in eastern Asia ranged from 2.5% to 6.7% for at least weekly symptoms of heartburn and/or acid regurgitation and may be increasing. No reliable data are available on the prevalence of esophagitis in the general population. In case studies, the prevalence of reflux esophagitis ranged from 3.4% to 16.3%. Well-established risk factors for GERD in Asian populations included hiatus hernia and obesity. Age and male sex also may be risk factors. Chest pain is the predominant extraesophageal manifestation of GERD in China, whereas in Japan, a link with asthma has been implicated in patients with severe esophagitis. Conclusions: There is a paucity of studies reporting the prevalence of GERD in eastern and southeastern Asia. These results highlight the need for further epidemiologic studies using representative study populations and a standardized methodology. Recognition and awareness of GERD need to increase concomitantly to ensure appropriate diagnosis and treatment of the disease.