Shedding light on the epidemiology of gastroesophageal reflux disease in India--a big step forward.

Gastroesophageal reflux disease (GERD) is defined as a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. It is considered troublesome when mild symptoms occur two or more days a week, or moderate/severe symptoms occur one or more days a week [1]. This global definition underscores the importance of patient symptoms in the diagnosis of GERD. In western countries, GERD is the most common gastrointestinal disease [2]. It is associated with a huge economic burden and decreased quality of life [3–7]. In addition, GERD can be associated with worrisome complications such as strictures, Barrett’s esophagus (BE) and rarely, esophageal adenocarcinoma (EAC) [8]. GERD symptoms occur at least once a month in 44%, once a week in 20%, and daily in 7% of the adult US population [9–11]. However, studies describing the epidemiology of GERD in India and for that matter in south-east Asia, are sparse and traditionally, GERD is thought to be uncommon in the developing countries [12]. Three important cohort studies published in this issue of the journal, although using slightly varying GERD definitions, draw our attention to the epidemiology of GERD in India and highlight that its prevalence may be similar to that in western countries.