Review article: prevalence and epidemiology of gastro-oesophageal reflux disease

There are considerable uncertainties around the definition and the appropriate clinical diagnostic criteria for gastro-oesophageal reflux disease (GERD), a common condition that appears to be increasing in prevalence in the Western world. Prevalence studies of GERD are hampered by whether any heartburn symptom is included, or just predominant or even 'sole' heartburn, and also by the time frame over which the symptoms have been evaluated. A systematic search of Medline using the keywords 'GERD''prevalence' and 'community' yielded three papers, two original articles and one systematic review of studies that surveyed symptoms in unselected subjects. Heartburn is a common symptom in Europe ranging from a prevalence of 38% in Northern Europe to 9% in Italy. Comparable 6-month data from the USA suggest an even higher prevalence with a rate of 42%. GERD is also a long-term, relapsing disorder. A population survey in Sweden found GERD symptoms over time at 18% of the population surveyed. In summary, although symptoms and quality of life improve with acid suppression therapy, costs are high and the potential benefit of long-term treatment is rare, but serious complications of GERD are unknown.