TY - JOUR T1 - Gastro-oesophageal reflux disease: a re-appraisal JF - British Journal of General Practice JO - Br J Gen Pract SP - 739 LP - 740 VL - 56 IS - 531 AU - Roger Jones Y1 - 2006/10/01 UR - http://bjgp.org/content/56/531/739.abstract N2 - Gastro-oesophageal reflux disease (GORD) is a common problem, with an estimated prevalence in western societies of 10–20% and a lower, but probably rising, prevalence in the east. A recent systematic review of the epidemiology of the condition found that wide variations in the diagnostic criteria used made comparison or meta-analysis of the various studies difficult.1Two years ago an expert group of 44 primary and secondary care clinicians from 18 countries embarked on a series of systematic reviews and a Delphi process to derive a new, globally-applicable definition of GORD that would be useful for clinicians and their patients, for researchers and for regulatory agencies. The report on the ‘Montreal Definition’ has recently been published in the American Journal of Gastroenterology and contains a number of important messages for primary care.2The cardinal symptoms of GORD are heartburn and regurgitation. However, lack of a gold standard for the diagnosis of GORD and the variable use of terminology in different studies and in different countries has created problems. Heartburn is now defined as a burning sensation in the retrosternal area and regurgitation as the perception of flow of refluxed gastric content into the mouth or hypopharynx. Reflux of acid gastric content is usually responsible for the symptoms of heartburn, although non-acid reflux of substances such as bile may be important in a minority of patients.3It is … ER -