Open Access Highly Accessed Research article

A population-based survey of the epidemiology of symptom-defined gastroesophageal reflux disease: the Systematic Investigation of Gastrointestinal Diseases in China

Jia He1, Xiuqiang Ma1, Yanfang Zhao1, Rui Wang1, Xiaoyan Yan1, Hong Yan2, Ping Yin3, Xiaoping Kang4, Jiqian Fang5, Yuantao Hao5, Qiang Li2, John Dent6, Joseph JY Sung7, Duowu Zou8, Mari-Ann Wallander1012, Saga Johansson9, Wenbin Liu11 and Zhaoshen Li8*

  • * Corresponding author: Zhaoshen Li

  • † Equal contributors

Author Affiliations

1 Department of Health Statistics, Second Military Medical University, Shanghai, China

2 Department of Health Statistics, Xi'an Jiao Tong University, Xi'an, China

3 Department of Health Statistics, Huazhong Science and Technology University, Wuhan, China

4 Department of Health Statistics, Peking University, Beijing, China

5 Department of Health Statistics, Zhongshan Medical University, Guangzhou, China

6 Department of Gastroenterology, Hepatology & General Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia

7 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China

8 Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

9 AstraZeneca R&D Mölndal, Sweden

10 Department of Public Health and Caring Sciences, Uppsala University, Sweden

11 Previous Address: R&D Medical Affairs, AstraZeneca Pharmaceutical Company Limited, Shanghai, China

12 Previous Address: AstraZeneca R&D Mölndal, Sweden

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BMC Gastroenterology 2010, 10:94  doi:10.1186/1471-230X-10-94

Published: 15 August 2010



The epidemiology of gastroesophageal reflux disease (GERD) has yet to be investigated using the symptomatic threshold criteria recommended by the Montreal Definition. This study aimed to determine the prevalence of symptom-defined GERD across five regions of China, and to investigate variables associated with GERD.


A representative sample of 18 000 adults (aged 18-80 years) were selected equally from rural and urban areas in each region (n = 1800). According to the Montreal Definition, GERD is present when mild symptoms of heartburn and/or regurgitation occur on ≥2 days a week, or moderate-to-severe symptoms of heartburn and/or regurgitation occur on ≥1 day a week.


In total, 16 091 participants completed the survey (response rate: 89.4%) and 16 078 responses were suitable for analysis. Applying the Montreal criteria, the prevalence of symptom-defined GERD was 3.1% and varied significantly (p < 0.001) among the five regions (from 1.7% in Guangzhou to 5.1% in Wuhan) and between rural and urban populations (3.8% vs 2.4%). Factors significantly associated with GERD included living in a rural area and a family history of gastrointestinal diseases.


This population-based survey found that the prevalence of symptom-defined GERD in China was 3.1%, which is lower than that found in Western countries.