A systematic review of the epidemiology of gastro-oesophageal reflux disease (GORD) has been performed, applying strict criteria for quality of studies and the disease definition used. The prevalence and incidence of GORD was estimated from 15 studies which defined GORD as at least weekly heartburn and/or acid regurgitation and met criteria concerning sample size, response rate, and recall period. Data on factors associated with GORD were also evaluated.

An approximate prevalence of 10–20% was identified for GORD, defined by at least weekly heartburn and/or acid regurgitation in the Western world while in Asia this was lower, at less than 5%. The incidence in the Western world was approximately 5 per 1000 person years. A number of potential risk factors (for example, an immediate family history and obesity) and comorbidities (for example, respiratory diseases and chest pain) associated with GORD were identified.

Data reported in this systematic review can be interpreted with confidence as reflecting the epidemiology of “true” GORD. The disease is more common in the Western world than in Asia, and the low rate of incidence relative to prevalence reflects its chronicity. The small number of studies eligible for inclusion in this review highlights the need for global consensus on a symptom based definition of GORD.

The study of the epidemiology of GORD is restricted by the lack of consensus over the basic definition of the disease. To review the global epidemiology of GORD is currently problematic as there is no internationally applied definition, although the need for this has been recognised.1 Gastro-oesophageal reflux manifests as a continuum of symptom frequency and/or severity in the general population. Occasional symptoms are experienced by a large proportion of the population but GORD results from frequent or severe symptoms which are sufficient to impair the individual’s health related quality of life …

https://gut.bmj.com/content/gutjnl/54/5/710.full.pdf

Epidemiology of gastro-oesophageal reflux disease: a systematic review

The American Productivity Audit (APA) is a telephone survey of a random sample of 28,902 U.S. workers designed to quantify the impact of health conditions on work. Lost productive time (LPT) was measured for personal and family health reasons and expressed in hours and dollars. Health-related LPT cost employers 225.8 billion US dollars/year (1685 US dollars/employee per year); 71% is explained by reduced performance at work. Personal health LPT was 30% higher in females and twice as high in smokers (> or =1 pack/day) versus nonsmokers. Workers in high-demand, low-control jobs had the lowest average LPT/week versus the highest LPT for those in low-demand, high-control jobs. Family health-related work absence accounted for 6% of all health-related LPT. Health-related LPT costs are substantial but largely invisible to employers. Costs vary significantly by worker characteristics, suggesting that intervention needs vary by specific subgroups.

Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit.

https://www.cghjournal.org/article/S1542-3565(06)00944-X/pdf

Time trends of gastroesophageal reflux disease: a systematic review.

Gastro-oesophageal reflux disease

Dyspepsia refers to group of upper gastrointestinal symptoms that occur commonly in adults. Dyspepsia is known to result from organic causes, but the majority of patients suffer from non-ulcer or functional dyspepsia. Epidemiological data from population-based studies of various geographical locations have been reviewed, as they provide more realistic information. Population-based studies on true functional dyspepsia (FD) are few, due to the logistic difficulties of excluding structural disease in large numbers of people. Globally, the prevalence of uninvestigated dyspepsia (UD) varies between 7%-45%, depending on definition used and geographical location, whilst the prevalence of FD has been noted to vary between 11%-29.2%. Risk factors for FD have been shown to include females and underlying psychological disturbances, whilst environmental/ lifestyle habits such as poor socio-economic status, smoking, increased caffeine intake and ingestion of non-steroidal anti-inflammatory drugs appear to be more relevant to UD. It is clear that dyspepsia and FD in particular are common conditions globally, affecting most populations, regardless of location.

Epidemiology of functional dyspepsia: a global perspective.

Background:
There is not at present a suitable disease-specific health-related quality of life instrument for uninvestigated dyspepsia and functional (non-ulcer) dyspepsia

Aim:
To develop a new multi-dimensional disease-specific instrument

Methods:
The Nepean Dyspepsia Index (NDI) was designed to measure impairment of a subject’s ability to engage in relevant aspects of their life and also their enjoyment of these aspects; in addition, the individual importance of each aspect is assessed A 42-item quality of life measure was developed and tested, both in out-patients presenting to general practice with upper gastrointestinal complaints (n = 113) and in a randomly chosen population-based sample (n = 347)

Results:
Adequate face and content validity was documented by an expert panel Factor analysis identified four clinically relevant subscales: interference with activities of daily living, work, enjoyment of life and emotional well-being; lack of knowledge and control over the illness; disturbance to eating or drinking; and disturbance to sleep because of dyspepsia These scales had high internal consistency Both symptoms and the quality of life scores discriminated dyspepsia from health

Conclusion:
The Nepean Dyspepsia Index is a reliable and valid disease-specific index for dyspepsia, measuring symptoms and health-related quality of life

Development of a new dyspepsia impact scale: the Nepean Dyspepsia Index.

Aims To describe the prevalence and severity of dyspepsia and gastro-oesophageal reflux in the community, to investigate their association with lifestyle factors and to evaluate the consultation pattern for these conditions. Method A previously validated questionnaire was posted to 1000 adults randomly selected from the electoral rolls of the greater Wellington region. It investigated symptoms of dyspepsia, reflux, lifestyle and consultation pattern over the previous twelve months. Results Response rate was 81.7%. Prevalence of dyspepsia was 34.2%. Prevalence of reflux was 30%. The overall prevalence of both symptom groups combined was 45.2%. Most subjects had multiple symptoms. Results indicated 63% of subjects with reflux also had symptoms of dyspepsia and 56% of subjects with dyspepsia showed symptoms of reflux. Although 69% of subjects with heartburn used over-the-counter medications, only 17% consulted medical practitioners. Current and ex-smokers had a higher prevalence of reflux. Dyspeptic symptoms were not associated with alcohol intake or aspirin use. Prevalence of dyspeptic symptoms did not change with increasing age. Conclusions Dyspepsia is very common in the community. Significant overlap among the subgroups of dyspepsia makes a classification, based on symptoms alone, of questionable value. Frequency and severity of symptoms should be incorporated in the definition to exclude those subjects with trivial symptoms.

J W Wyeth

Papers

Development of a new dyspepsia impact scale: the Nepean Dyspepsia Index.

Prevalence, severity and associated features of gastro-oesophageal reflux and dyspepsia: a population-based study.