Worldwide Epidemiology of Gastroesophageal Disease, continued importantly, there is an exceedingly high prevalence of Helicobacter pylori (Hp) in under-resourced populations. It is possible that Hp infection may, in some manner, affect the prevalence or mode of presentation of GERD or it may be that higher living standards lead, independently, to a decreased risk of Hp infection and an increased food intake and obesity. Extraesophageal and additional symptoms As previously mentioned, GERD affects different organ systems and may be related to different conditions, such as cough, asthma, or hoarseness (Table 2). There is no study comparing the atypical symptoms between different countries, but studies that were performed using the same questionnaire have yielded different results. For example, the prevalence of asthma among GERD patients ranges from 0.8% to 9.3%. The prevalence of other symptoms, such as dyspepsia, also differs markedly, ranging from 10.6% to 60.2%. Conclusions 1) The prevalence of GERD is higher in Western countries (15- 25%) than in Eastern countries (3%-16%). 2) The symptom profile of GERD is different: heartburn is more prevalent in Western countries, whereas regurgitation is the predominant symptom in the East. 3) Additional and extra-esophageal symptoms are common in GERD subjects, but the prevalence of each symptom varies significantly among studies. References 1. Bhatia SJ, Reddy DN, Ghoshal UC, Jayanthi V, Abraham P, Choudhuri G, et al. Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol 2011;30:118-27 2. Bor S, Mandiracioglu A, Kitapcioglu G, Caymaz-Bor C, Gilbert RJ. Gastroesophageal reflux disease in a low-income region in Turkey. Am J Gastroenterol 2005;100:759-65. 3. Bor S, Lazebnik LB, Kitapcioglu G, Manannikof I, Vasiliev Y. Prevalence of Gastroesophageal Reflux Disease in Moscow. Dis Esophagus (21 Jan 2015) DOI: 10.1111/dote.12310 4. Breckan RK, Paulssen EJ, Asfeldt AM, Mortensen L, Straume B, Florholmen J. The impact of body mass index and Helicobacter pylori infection on gastro-oesophageal reflux symptoms: a population-based study in Northern Norway. Scand J Gastroenterol 2009;44:1060-6 5. Chiocca JC, Olmos JA, Salis GB, Soifer LO, Higa R, Marcolongo M; Argentinean Gastro-oesophageal reflux study group. Prevalence, clinical spectrum and atypical symptoms of gastro-oesophageal reflux in Argentina: a nationwide population based study. Aliment Pharmacol Ther 2005;22:331-42. 6. Diaz-Rubio M, Moreno-Elola-Olaso C, Rey E, Locke GR 3rd, Rodriguez-Artalejo F. Symptoms of gastro-oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther 2004;19:95-105. 7. Ho KY. Gastroesophageal reflux disease in Asia: a condition in evolution. J Gastroenterol Hepatol 2008;23:716-22 8. Locke GR, Talley NJ, Fett SL, Zinmeister AR, Melton LJ. Prevalence and clinical spectrum of gastroesophageal reflux: A population based study in Olmsted County, Minnesota. Gastroenterology 1997;112;1448-1456. 9. Miyamoto M, Haruma K, Kuwabara M, Nagano M, Okamoto T, Tanaka M. High incidence of newly-developed gastroesophageal reflux disease in the Japanese community: a 6-year follow-up study. J Gastroenterol Hepatol 2008;23:393-7 10. Moshkowitz M, Horowitz N, Halpern Z, Santo E. Gastroesophageal reflux disease symptoms: prevalence, sociodemographics and treatment patterns in the adult Israeli population. World J Gastroenterol. 2011;17:1332-5. 11. Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling Sternevald E, et al. High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: a Kalixanda study report. Scand J Gastroenterol 2005;40:275-85. 12. Vossoughinia H, Salari M, Mokhtari Amirmajdi E, Saadatnia H, Abedini S, Shariati A, Shariati M, Khosravi Khorashad A. An epidemiological study of gastroesophageal reflux disease and related risk factors in urban population of Mashhad, Iran. Iran Red Crescent Med J 2014;16:e15832. 13. Wang JH, Luo JY, Dong L, Gong J, Tong M. Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi’an of Northwest China. World J Gastroenterol 2004;10:1647-51. 14. Wong WM, Lai KC, Lam KF, Hui WM, Hu WH, Lam CL, et al. Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study. Aliment Pharmacol Ther 2003;18:595-604 15. Yuen E, Romney M, Toner RW, Cobb NM, Katz PO, Spodik M, Goldfarb NI. Prevalence, knowledge and care patterns for gastro-oesophageal reflux disease in United States minority populations. Aliment Pharmacol Ther 2010;32:645-54. World Digestive Health Day WDHD May 29, 2015 WGO HANDBOOK HEARTBURN: A GLOBAL PERSPECTIVE 13
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