Natural history of gastro-oesophageal reflux disease diagnosed in general practice.
Aliment Pharmacol Ther. 2004;20:751-760
ABSTRACT
Aim: To determine the natural history of GORD presenting in primary care in the
UK.
Methods: Patients with a first diagnosis of GORD during 1996 were identified in
the UK General Practice Research Database and compared to age- and sex-matched c
ontrols. We investigated the incidence of GORD, potential risk factors and comor
bidities, and relative risk (RR) for subsequent oesophageal complications and mo
rtality.
Results: The incidence of a GORD diagnosis was 4.5 per 1000 person-years (95% co
nfidence interval[CI]:4.4-4.7). Prior use of NSAIDs, smoking, excess body weight
and gastrointestinal and cardiac conditions were associated with an increased r
isk of GORD diagnosis. Subjects with GORD had an increased risk of respiratory p
roblems, chest pain and angina in the year after diagnosis, and had a RR of 11.5
(95%CI:5.9-22.3) of being diagnosed with an oesophageal complication. There was
an increase in mortality in the GORD cohort only in the year following the diag
nosis.
Conclusions: GORD is a disease associated with a range of potentially serious oe
sophageal complications and extra-oesophageal diseases.
Background: Cross-sectional studies indicate that gastro-oesophageal reflux dise
ase (GORD) symptoms have a prevalence of 10-20% in Western countries and are ass
ociated with obesity, smoking, oesophagitis, chest pain and respiratory disease.