Natural history of gastro-oesophageal reflux disease diagnosed in general practice

Aliment Pharmacol Ther. 2004 Oct 1;20(7):751-60. doi: 10.1111/j.1365-2036.2004.02169.x.


Background: Cross-sectional studies indicate that gastro-oesophageal reflux disease symptoms have a prevalence of 10-20% in Western countries and are associated with obesity, smoking, oesophagitis, chest pain and respiratory disease.

Aim: To determine the natural history of gastro-oesophageal reflux disease presenting in primary care in the UK.

Methods: Patients with a first diagnosis of gastro-oesophageal reflux disease during 1996 were identified in the UK General Practice Research Database and compared with age- and sex-matched controls. We investigated the incidence of gastro-oesophageal reflux disease, potential risk factors and comorbidities, and relative risk for subsequent oesophageal complications and mortality.

Results: The incidence of a gastro-oesophageal reflux disease diagnosis was 4.5 per 1000 person-years (95% confidence interval: 4.4-4.7). Prior use of non-steroidal anti-inflammatory drugs, smoking, excess body weight and gastrointestinal and cardiac conditions were associated with an increased risk of gastro-oesophageal reflux disease diagnosis. Subjects with gastro-oesophageal reflux disease had an increased risk of respiratory problems, chest pain and angina in the year after diagnosis, and had a relative risk of 11.5 (95% confidence interval: 5.9-22.3) of being diagnosed with an oesophageal complication. There was an increase in mortality in the gastro-oesophageal reflux disease cohort only in the year following the diagnosis.

Conclusions: Gastro-oesophageal reflux disease is a disease associated with a range of potentially serious oesophageal complications and extra-oesophageal diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Antirheumatic Agents / adverse effects
  • Child
  • Child, Preschool
  • Cohort Studies
  • Family Practice / statistics & numerical data
  • Female
  • Gastroesophageal Reflux / etiology*
  • Gastroesophageal Reflux / mortality
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Nitrates / adverse effects
  • Patient Acceptance of Health Care / statistics & numerical data
  • Risk Factors
  • Steroids / adverse effects
  • United Kingdom / epidemiology


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Nitrates
  • Steroids