Natural history of gastroesophageal reflux disease and functional abdominal disorders: A population-based study

OBJECTIVE: Symptomatic gastroesophageal reflux disease (GERD), dyspepsia, a nd irritable bowel syndrome (IBS) are generally considered to be chronic co nditions, but community-based studies are sparse, and long-term natural his tory data are unavailable. We aimed to determine the natural history of the se conditions. METHODS: A representative Swedish sample (20-79 yr) completed a validated q uestionnaire over the preceding 3 months. The survey was repeated after 1 a nd 7 yr in the same target group (n = 1290, 1260, and 1065; response rates 90%, 87%, and 82%, respectively; 79% responded to all three mailings). RESULTS: The prevalence of GERD symptoms remained stable, whereas the preva lence of IBS increased over time, independent of aging. Dyspepsia decreased with advancing age. Although more than half of those with IBS reported the same symptom profile after 1 and 7 yr, there was a substantial symptom flu ctuation and symptom profile flux between those reporting dyspepsia, IBS, o r minor symptoms. Only a minority with GERD (<10%) changed to dyspepsia and /or IBS, or vice versa. The symptom-free patients remained symptom-free or reported only minor symptoms in <greater than or equal to>90% of cases. CONCLUSION: There seem to be two distinct populations of symptom reporters, those with dyspepsia or IBS, and those with GERD. (Am J Gastroenterol 2001 ;96:2905-2914. (C) 2001 by Am. Coll. of Gastroenterology).