Epidemiology of oesophageal reflux disease.

Because of inconsistency in terminology and history of diagnosis of gastro-oesophageal reflux disease, accurate epidemiologic information is difficult to compile. Historically, heartburn has been recognised as the classic symptom of gastro-oesophageal reflux disease. Five per cent of the Western adult population experiences heartburn with some frequency. Heartburn may be the sole basis for diagnosis, but many patients have less specific symptoms that do not allow a reliable diagnosis solely from clinical features. No more than two-thirds of patients with gastro-oesophageal reflux disease have oesophagitis on endoscopy. The peak age distribution for patients with gastro-oesophageal reflux disease ranges between 60 and 70 years. Clinical reports concerning long-term natural history and management are scarce. In some patients there is spontaneous improvement without drug therapy. Five to 10% of patients referred to the hospital with gastro-oesophageal reflux disease require antireflux surgery, but most patients are treated by primary-care physicians.