Epidemiology and natural history of gastro-oesophageal reflux disease

Research output: Contribution to journalArticle

418 Citations (Scopus)

Abstract

Epidemiological studies of gastro-oesophageal reflux disease (GORD) are confounded by the lack of a standardized definition and a diagnostic 'gold-standard' for the disorder. In Western countries, 20-40% of the adult population experience heartburn, which is the cardinal symptom of GORD, but only some 2% of adults have objective evidence of reflux oesophagitis. The incidence of GORD increases with age, rising dramatically after 40 years of age. There is also wide geographical variation in prevalence. Complications, including oesophageal ulcer and stricture, and Barrett's oesophagus, are found in up to 20% of patients with verified reflux oesophagitis. The signs and symptoms of GORD often wax and wane in intensity, and spontaneous remissions have been reported. In most cases. however, GORD is a chronic condition that returns shortly after discontinuing therapy. Although GORD causes substantial morbidity, the annual mortality rate due to GORD is very low (approximately 1 death per 100,000 patients), and even severe GORD has no apparent effect on longevity, although the quality of life can be significantly impaired. There are data to suggest that the use of non-steroidal anti-inflammatory drugs (NSAIDs) contributes to oesophagitis and stricture formation in patients with GORD. Although these data are not conclusive, it seems prudent, if possible, to avoid the use of NSAIDs in patients with GORD, particularly those with oesophageal stricture.

Original languageEnglish (US)
Pages (from-to)24-29
Number of pages6
JournalDigestion
Volume51
Issue numberSUPPL. 1
StatePublished - 1992

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Esophageal Diseases
Gastroesophageal Reflux
Epidemiology
Esophageal Stenosis
Peptic Esophagitis
Anti-Inflammatory Agents
Spontaneous Remission
Heartburn
Barrett Esophagus
Esophagitis
Waxes
Gold
Pharmaceutical Preparations
Signs and Symptoms
Ulcer
Epidemiologic Studies
Pathologic Constriction
Quality of Life

Keywords

  • Epidemiology
  • Gastro-oesophageal reflux
  • Natural history
  • Non-steroidal antiinflammatory drugs
  • Peptic oesophagitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Epidemiology and natural history of gastro-oesophageal reflux disease. / Spechler, S. J.

In: Digestion, Vol. 51, No. SUPPL. 1, 1992, p. 24-29.

Research output: Contribution to journalArticle

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