Journal of Gastroenterology and Hepatology (2005) 20, 26–29 DOI: 10.1111/j.1400-1746.2004.03521.x Blackwell Science, LtdOxford, UKJGHJournal of Gastroenterology and Hepatology0815-93192004 Blackwell Publishing Asia Pty Ltd2012629Original Article Gastroesophageal reflux disease in JapanY Fujiwara et al. Correspondence: Dr Yasuhiro Fujiwara, Department of Gastroenterology, Osaka City University, Graduate School of Medi- cine, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan. Email: yasu@med.osaka-cu.ac.jp Accepted for publication 29 January 2004. GASTROENTEROLOGY Prevalence of gastroesophageal reflux disease and gastroesophageal reflux disease symptoms in Japan YASUHIRO FUJIWARA,* KAZUHIDE HIGUCHI,* YOKO WATANABE,* MASATSUGU SHIBA,* TOSHIO WATANABE,* KAZUNARI TOMINAGA,* NOBUHIDE OSHITANI,* TAKAYUKI MATSUMOTO,* HIDEKI NISHIKAWA † AND TETSUO ARAKAWA* *Department of Gastroenterology, Osaka City University Graduate School of Medicine and † Nagahori Clinic, Osaka, Japan Abstract Background and Aim: Epidemiological studies have shown that 10–48% of people in developed countries have gastroesophageal reflux disease (GERD) symptoms such as heartburn and acid regurgi- tation. The present study aimed to examine the prevalence of GERD symptoms and GERD in Japanese subjects. Methods: A cross-sectional study of Japanese subjects who visited a clinic for a routine health check up was carried out. Subjects were asked to fill out a self-report questionnaire. GERD was defined as the presence of heartburn and/or acid regurgitation at least twice per week. Results: Of the 6035 eligible subjects, 2662 (44.1%) reported having had heartburn and/or acid regur- gitation during the past year: 124 (2.1%) daily, 275 (4.6%) twice per week, 773 (12.8%) twice per month and 1490 (24.7%) less than twice per month. Three hundred and ninety-nine (6.6%) subjects were diagnosed as having GERD and there was no relationship between the prevalence of GERD and either sex or age. The prevalence of bothersome GERD symptoms was significantly higher in subjects with GERD than in those without GERD. Conclusion: Approximately 6.6% of Japanese have GERD and most persons with GERD described heartburn or acid regurgitation as bothersome. © 2005 Blackwell Publishing Asia Pty Ltd Key words: acid regurgitation, epidemiology, gastroesophageal reflux disease, heartburn, Japanese subjects. INTRODUCTION Gastroesophageal reflux disease (GERD) is caused by the abnormal reflux of gastric content into the esopha- gus. GERD is characterized by specific symptoms such as heartburn and acid regurgitation. 1 Epidemiological studies have shown that the prevalence of GERD symp- toms in developed countries ranges from 10% to 48% 2 and a recent Gallop survey in the USA found that 44% of adults experience heartburn at least once per month. 3 GERD includes reflux esophagitis and endoscopy- negative (non-erosive or symptomatic) GERD. Only one-third of GERD patients have endoscopically posi- tive findings, such as erosions and ulcers, while others have no obvious mucosal breaks during endoscopic examination even though GERD symptoms are present. 4 The presence of GERD symptoms has a sig- nificant negative impact on health-related quality of life: 5,6 patients have reported more frequent interrup- tions during sleep, work, and social events 5 and worse emotional well-being than those with diabetes or hyper- tension. 6 Lagergren et al. demonstrated that the relative risk for esophageal adenocarcinoma was 43.5 for those with long-lasting severe GERD symptoms. 7 Therefore, GERD symptoms are clinically important and are an alarm for esophageal adenocarcinoma. Although the prevalence of GERD in Japan was con- sidered to be lower than that in other developed coun-