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


OBJECTIVE
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.
Ruigómez
A
A
Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain. aruigomez@ceife.es
García Rodríguez
L A
LA
Wallander
M-A
MA
Johansson
S
S
Graffner
H
H
Dent
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000009:adverse effects; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects; D006113:United Kingdom / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D009566:Nitrates; D013256:Steroids