Gastroesophageal reflux disease (GERD), also called gastro-oesophageal reflux disease (GORD), affects people across regions and age groups. Available studies measure different things—symptoms, diagnosed cases, healthcare use, incidence, prevalence, and years lived with disability—so the figures below should be read with their specific year, geography, and definition in mind.
Contents
- How common is GERD?
- Global trends from 1990 to 2021
- Age and sex patterns
- Where is the burden highest?
- U.S. healthcare statistics
- Prevalence estimates and country figures
- Risk-factor associations
How common is GERD?
The best-known global estimates differ according to study design. A 2020 meta-analysis estimated that 1.03 billion people worldwide suffered from GORD. In the same analysis, prevalence ranged from 2.5% in China to 51.2% in Greece. This wide range reflects differences among populations and studies, including how symptoms and disease are defined and measured. [Gut meta-analysis]
A separate large pregnancy meta-analysis, published in 2025 and citing the earlier global estimate, reported a pooled prevalence of 13.3% for heartburn or regurgitation occurring at least weekly. That measure describes weekly symptoms in pregnancy-focused evidence; it is not interchangeable with a general-population estimate of diagnosed GERD. [BMC Pregnancy and Childbirth 2025]
In the United States, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) reported that reflux symptoms at least weekly affected 20% of the population in 2004. The year matters: this is a U.S. estimate from 2004, not a current prevalence estimate. [NIDDK Digestive Diseases Statistics for the United States]
Global burden studies provide another lens. The GBD 2021 GERD update estimated 825.6 million prevalent GERD cases worldwide in 2021, compared with 450.8 million in 1990. It estimated 324.1 million incident cases in 2021, compared with 180.0 million in 1990. These are modeled burden estimates rather than a headcount from a single worldwide survey. [GBD 2021 GERD update]
Global trends from 1990 to 2021
The GBD 2021 update reported increases across several measures between 1990 and 2021:
| Measure | 1990 | 2021 | Reported change |
|---|---|---|---|
| Prevalent cases | 450.8 million | 825.6 million | 83.2% increase |
| Incident cases | 180.0 million | 324.1 million | 80.1% increase |
| Years lived with disability (YLDs) | 3.47 million | 6.34 million | 82.7% increase |
| Age-standardized prevalence rate | 9,616.49 per 100,000 | 9,838.60 per 100,000 | Increased |
| Age-standardized incidence rate | 3,739.86 per 100,000 | 4,015.67 per 100,000 | Increased |
| Age-standardized YLD rate | 73.01 per 100,000 | 75.56 per 100,000 | Increased |
The counts and rates answer different questions. Prevalent cases describe the number of people living with the condition in a year, while incident cases describe newly occurring cases. YLDs capture time lived with health loss. Age-standardized rates adjust for population age structure, making long-term or geographic comparisons more informative than raw counts alone.
The scale of the increase is also visible in the older GBD 2019 analysis. That study estimated 441.6 million global prevalent cases in 1990 and 783.9 million in 2019. Its global age-standardized prevalence rose from 9,344.52 per 100,000 in 1990 to 9,574.45 per 100,000 in 2019. Global YLD counts rose from 3.40 million in 1990 to 6.03 million in 2019, while the age-standardized YLD rate rose from 71.68 to 73.63 per 100,000. [BMC Public Health 2023 GBD 2019 study]
These 2019 and 2021 estimates should not be combined as though they were one continuous measurement series. They come from different study updates and end years, although both describe a large global GERD burden.
Age and sex patterns
The GBD 2021 GERD update found that the 15-to-49-year age group carried the highest prevalence burden and the highest incidence burden. The 50-to-69-year age group carried the highest YLD burden. In other words, the age group with the most prevalent or incident burden was not the same as the age group with the greatest modeled disability burden.
The same update reported higher global female prevalent cases, incident cases, and DALY cases than male cases in 2021. Its age-standardized rates also showed higher female values:
| Measure | Female, 1990 | Female, 2021 | Male, 1990 | Male, 2021 |
|---|---|---|---|---|
| Prevalence rate per 100,000 | 9,898.36 | 10,229.08 | 9,130.43 | 9,442.63 |
| Incidence rate per 100,000 | 3,879.78 | 4,025.55 | 3,599.47 | 3,737.01 |
The female and male comparisons are age-standardized rates, while the statement about higher female cases concerns global counts. Counts and rates can differ in interpretation because population size and age structure are not the same across groups. [GBD 2021 GERD update]
A population-based study in Iran reported an odds ratio of 1.55 for frequent GERD associated with female sex. That result is specific to the study population and outcome definition; it does not establish a universal risk ratio for every population. [Sex and Gender Differences in GERD review]
Where is the burden highest?
The GBD 2021 study identified both a socioeconomic-development pattern and a regional pattern. In 2021, the low-middle-SDI region had the highest age-standardized incidence rate at 4,894.02 per 100,000, the highest age-standardized prevalence rate at 12,563.56 per 100,000, and the highest age-standardized DALY rate at 96.06 per 100,000. [BMC Gastroenterology 2025 GBD 2021 study]
Tropical Latin America recorded the highest regional values in that analysis: an age-standardized incidence rate of 6,248.12 per 100,000, an age-standardized prevalence rate of 16,681.34 per 100,000, and an age-standardized DALY rate of 127.65 per 100,000 in 2021. These are standardized regional rates, not the number of people living in the region.
The earlier GBD 2019 study also placed Latin American regions at the top for age-standardized prevalence in 2019. Tropical Latin America had a rate of 16,207.5 per 100,000, Central Latin America had 15,949.53 per 100,000, the Caribbean had 15,935.32 per 100,000, and Andean Latin America had 15,932.06 per 100,000. [BMC Public Health 2023 GBD 2019 study]
The 2021 analysis reported that High-income North America’s age-standardized incidence rate fell by 0.48% per year. That annual percentage change is a trend measure for the region and should not be read as a 0.48% reduction in every individual’s risk. [BMC Gastroenterology 2025 GBD 2021 study]
U.S. healthcare statistics
NIDDK’s Digestive Diseases Statistics for the United States reported substantial GERD-related healthcare activity during the late 2000s and earlier. GERD accounted for 8.9 million ambulatory care visits in the United States in 2009 and 4.7 million hospitalizations in 2010. The same source reported 1,653 U.S. deaths attributed to GERD in 2010 and 64.6 million GERD prescriptions in 2004. [NIDDK Digestive Diseases Statistics for the United States]
| U.S. measure | Year | Reported figure |
|---|---|---|
| Reflux symptoms at least weekly | 2004 | 20% of the population |
| GERD prescriptions | 2004 | 64.6 million |
| Ambulatory care visits | 2009 | 8.9 million |
| Hospitalizations | 2010 | 4.7 million |
| Deaths attributed to GERD | 2010 | 1,653 |
These figures measure different forms of healthcare use and mortality. A prescription count is not a count of unique patients, and visits or hospitalizations are events rather than prevalence estimates. Because the measurements are from different years, they also should not be interpreted as one same-year U.S. snapshot.
The GBD 2019 study estimated 39.7 million GERD incidence cases in the USA in 2019. It reported an annual percent change of -0.497% in the U.S. prevalence rate, described as the steepest decline reported in that paper. [BMC Public Health 2023 GBD 2019 study]
Prevalence estimates and country figures
Country-level figures show why geography and metric labels are essential. In the GBD 2019 study, India had 181.6 million GERD incidence cases in 2019, China had 81.6 million, and the USA had 39.7 million. These are incidence cases for one year in the study’s modeled framework; they are not prevalence totals and do not directly rank symptom frequency.
The same study reported Sweden as having the largest positive annual percent change in GERD prevalence rate at 0.216% in 2019. It also identified the USA’s -0.497% annual percent change as the steepest decline reported in the paper. Annual percent change summarizes a trend over the study’s modeled period; it does not mean that Sweden had the highest prevalence rate or that the USA had the lowest rate.
The 2019 analysis found GERD YLD rates above 123 per 100,000 in Paraguay, Brazil, Bermuda, the Bahamas, Colombia, Barbados, the Dominican Republic, Costa Rica, Ecuador, the U.S. Virgin Islands, Peru, and Venezuela. This is a threshold statement about disability burden, not a prevalence percentage. [BMC Public Health 2023 GBD 2019 study]
Risk-factor associations
Several studies quantified associations between GERD and body size or related exposures. A 2025 dose-response systematic review and meta-analysis of 43 papers involving 484,219 participants reported a relative risk of 1.374 for the association between BMI and GERD risk. In the same analysis, BMI was associated with symptomatic GER with a relative risk of 2.041. These estimates describe associations from a meta-analysis and do not show that BMI alone causes every case.
An obesity-focused meta-analysis cited by the International Journal of Epidemiology reported an adjusted odds ratio of 1.73 for obesity and GERD symptoms. A separate meta-analysis summarized by NICE-info reported an odds ratio of 1.57 for overweight and reflux symptoms and 2.15 for obesity and reflux symptoms. The differing estimates reflect differing evidence sets, definitions, and statistical models. [International Journal of Epidemiology] [Nice-info summary of meta-analysis]
A 2022 Mendelian randomization study reported an odds ratio of 1.49 for GERD per one standard-deviation increase in BMI. It also reported an odds ratio of 1.41 per one standard-deviation increase in smoking-initiation prevalence and an odds ratio of 1.07 per unit increase in the log-transformed type 2 diabetes odds ratio. These are genetically instrumented associations, not ordinary prevalence percentages. [PubMed 2022]
Taken together, the available figures describe GERD as a large and geographically variable burden, with global modeled counts and disability measures rising between 1990 and 2021. The estimates also show why a useful GERD statistic should always identify its outcome, measurement year, geography, population, and study method.