The evaluation and treatment of adults with gastroesophageal reflux disease.

Gastroesophageal reflux disease (GERD) is defined as symptoms or tissue damage that results from the abnormal reflux of gastric contents into the esophagus. A systematic review of population-based studies estimates that heartburn or regurgitation symptoms occur in 21% to 59% of the population during a given year. The frequency of GERD in specific populations is provided in Table 1. Although only 1 in 5 patients with upper intestinal symptoms that occur at least weekly seeks medical attention, nearly 1% of all visits to a family physician's office are for GERD or related conditions. GERD significantly affects the quality of patients' lives. In a survey of patients presenting for upper endoscopy with symptoms of at least 3 months' duration, those with a diagnosis of GERD reported low scores at baseline for general well-being. Fortunately, follow-up data reported 4 weeks after treatment note improvement in gastrointestinal symptoms, general well-being, general health, vitality, and depression.