Original ResearchFull Report: Clinical—Alimentary TractPrevalence of Gastroesophageal Reflux Disease and Proton Pump Inhibitor-Refractory Symptoms
Graphical abstract
Section snippets
Study Design, Data Source, and Study Population
In October 2015, our group conducted the “National Gastrointestinal (GI) Survey,” a population-based audit of GI symptoms in more than 71,000 community-dwelling Americans.12, 13, 14, 15 The survey was administered via MyGiHealth, a mobile app that uses AEGIS (Automated Evaluation of GI Symptoms), an automated algorithm that has previously been described in detail.16 AEGIS asked users to “Select any symptom(s) you experienced in the past week” and “Please check any of these GI symptom(s) that
Study Cohort
In all, 1.3 million individuals were invited to complete the National GI Survey with the opportunity to participate in the study up until at least 70,000 surveys were completed. Ultimately, 124,674 (9.4%) individuals accessed the survey, of whom 71,812 (57.6%) completed the questionnaires and were included in the study. Table 1 lists the demographic information of the study cohort.
GERD Symptoms Within the Past 7 Days Among Overall Cohort
Among 71,812 participants, we found that 32,878 (PW 44.1%) had ever experienced GERD symptoms in the past and
Discussion
In this population-based survey, we found that GERD symptoms are very common in the community. More than 2 of 5 Americans have experienced heartburn or regurgitation in the past, whereas nearly 1 of 3 experienced these symptoms in the past week. In addition, among those managing their symptoms with a daily PPI, we found that more than half still have persistent, troublesome GERD symptoms.
Our prevalence of presumptive GERD is largely in line with prior estimates from other US cross-sectional and
Acknowledgments
Author contributions: Sean D. Delshad: study design; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content. Christopher V. Almario: study concept and design; acquisition of data; analysis and interpretation of data; statistical analysis; drafting of the manuscript; critical revision of the manuscript for important intellectual content; administrative, technical, or material support; study supervision. William D.
References (50)
The economic and quality-of-life impact of symptomatic gastroesophageal reflux disease
Am J Gastroenterol
(2003)- et al.
The impact of gastroesophageal reflux disease on health-related quality of life
Am J Med
(1998) - et al.
Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018
Gastroenterology
(2019) - et al.
Gastroesophageal reflux among different racial groups in the United States
Gastroenterology
(2004) - et al.
Prevalence and socioeconomic impact of upper gastrointestinal disorders in the United States: results of the US Upper Gastrointestinal Study
Clin Gastroenterol Hepatol
(2005) - et al.
Old farts - fact or fiction? Results from a population-based survey of 16,000 Americans examining the association between age and flatus
Clin Gastroenterol Hepatol
(2017) - et al.
Prevalence of and factors associated with fecal incontinence: results from a population-based survey
Gastroenterology
(2018) Time trends of gastroesophageal reflux disease: a systematic review
Clin Gastroenterol Hepatol
(2007)- et al.
Risk factors associated with symptoms of gastroesophageal reflux
Am J Med
(1999) - et al.
Epidemiology of gastroesophageal reflux disease
Gastroenterol Clin North Am
(2014)
Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea
Am J Gastroenterol
Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications?
Gastroenterology
The effect of psychological stress on symptom severity and perception in patients with gastro-oesophageal reflux
J Psychosom Res
Prevalence of functional gastrointestinal disorders in a population of subjects consulting for gastroesophageal reflux disease in general practice
Gastroenterol Clin Biol
875-IW-3718, a novel gastric-retentive bile acid sequestrant, improved heartburn and regurgitation symptoms in patients with persistent GERD despite PPI treatment: a double-blind, placebo-controlled study
Gastroenterology
The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus
Am J Gastroenterol
Gastroesophageal reflux disease (GERD): risk factors, and impact on quality of life-a population-based study
J Clin Gastroenterol
Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies
Aliment Pharmacol Ther
Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review
Gut
Population distribution by race/ethnicity. 2017
Ethnic differences in gastro-oesophageal reflux disease
Eur J Gastroenterol Hepatol
Burden of gastrointestinal symptoms in the United States: results of a nationally representative survey of over 71,000 Americans
Am J Gastroenterol
Lower and upper gastrointestinal symptoms differ between individuals with irritable bowel syndrome with constipation or chronic idiopathic constipation
J Neurogastroenterol Motil
Computer-generated vs. physician-documented history of present illness (HPI): results of a blinded comparison
Am J Gastroenterol
Construct validity of the Patient-Reported Outcomes Measurement Information System gastrointestinal symptom scales in systemic sclerosis
Arthritis Care Res (Hoboken)
Cited by (117)
Burden and Treatment of Chronic Upper GI Symptoms and Diagnoses: A Nationwide Study
2024, Clinical Gastroenterology and HepatologyGood clinical practice recommendations for the diagnosis and treatment of gastroesophageal reflux disease. An expert review from the Asociación Mexicana de Gastroenterología
2024, Revista de Gastroenterologia de MexicoEsophageal Symptoms and Lumbosacral Back Pain
2024, Gastro Hep AdvancesCo-Morbidities of Irritable Bowel Syndrome in a Racially and Ethnically Diverse Population
2024, Journal of Clinical MedicineCurrent Management and Treatment Paradigms of Gastroesophageal Reflux Disease following Sleeve Gastrectomy
2024, Journal of Clinical Medicine
Conflicts of interest Brennan M.R. Spiegel and William D. Chey are consultants for Ironwood Pharmaceuticals and patent holders and principals at My Total Health. Christopher V. Almario has a stock option grant in My Total Health. Sean D. Delshad discloses no conflicts.
FundingThis study was funded by Ironwood Pharmaceuticals. The study sponsor did not have a role in the collection, analysis, or interpretation of data, or drafting of the manuscript. The Cedars-Sinai Center for Outcomes Research and Education (CS-CORE) is supported by The Marc and Sheri Rapaport Fund for Digital Health Sciences & Precision Health. Christopher V. Almario was supported by a career development award from the American College of Gastroenterology. Christopher V. Almario and Brennan M.R. Spiegel are supported by National Institutes of Health/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant UL1TR001881.
Author names in bold designate shared co-first authorship.
- ∗
Authors share co-first authorship.