Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review

Hashem B El-Serag, Stephen Sweet, Christopher C Winchester, John Dent, Hashem B El-Serag, Stephen Sweet, Christopher C Winchester, John Dent

Abstract

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%.

Keywords: Epidemiology; Gastroesophageal Reflux Disease.

Figures

Figure 1
Figure 1
Flowchart of systematic literature searches. GERD, gastro-oesophageal reflux disease; MeSH, medical subject heading.
Figure 2
Figure 2
Global distribution of the burden of gastro-oesophageal reflux disease. Sample-size weighted mean estimates of the prevalence of at least weekly heartburn and/or regurgitation in each country.

Source: PubMed

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