Systematic review: the epidemiology of gastro-oesophageal reflux disease in primary care, using the UK General Practice Research Database


Dr H. El-Serag, Gastroenterology and Hepatology Section, Department of Medicine, Michael E DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA.


Background  Gastro-oesophageal reflux disease (GERD) is a common diagnosis in primary care; however, there has been no comprehensive review of the epidemiology of GERD in this setting.

Aim  To review systematically articles that used the General Practice Research Database to study the epidemiology of GERD.

Methods  Systematic literature searches.

Results  Seventeen articles fulfilled the inclusion criteria. The incidence of GERD in primary care was 4.5 new diagnoses per 1000 person-years in 1996 (95% CI: 4.4–4.7). A new diagnosis of GERD was associated with being overweight, obese or an ex-smoker. Prior diagnoses of ischaemic heart disease, peptic ulcer disease, nonspecific chest pain, nonspecific abdominal pain, chronic obstructive pulmonary disease and asthma were associated with a subsequent new GERD diagnosis. A first diagnosis of GERD was associated with an increased risk of a subsequent diagnosis of oesophageal adenocarcinoma, oesophageal stricture, chronic cough, sinusitis, chest pain, angina, gallbladder disease, irritable bowel syndrome or sleep problems. Mortality may be higher in patients with a GERD diagnosis than in those without in the first year after diagnosis, but not long term.

Conclusion  The General Practice Research Database is an effective way of studying the epidemiology of GERD in a large population-based primary care setting.