[Gastroesophageal reflux in the French general population: national survey of 8000 adults].

Objectives: To assess the population-based prevalence in France of gastroesophageal reflux disease (GERD) and to report its characteristics, consultation rate, modes of management, as well as patients' satisfaction.

Methods: This epidemiological quantitative mail survey sent to a sample of 8000 persons representative of the French adult population comprised 46 questions about GERD, its risk factors, management, last episode, and satisfaction with treatment. GERD was defined in accordance with the guidelines of the 1999 consensus conference as the existence of typical symptoms (heartburn, acid regurgitation) and frequent GERD as occurring at a frequency of at least once a week.

Results: The overall prevalence of GERD in France is 31.3%. The prevalence of frequent GERD is 7.8% (6% among those younger than 50 years, 10% among those older than 50). Most subjects with frequent GERD (86%) had seen a doctor for it, often long after the first occurrence of symptoms - 26% had waited for more than one year before consulting - while 14% had never discussed it with a doctor, mainly because they considered it not serious and treated it themselves. Of those who had consulted, 58% had undergone an endoscopy. Most subjects (85%) had treated their last episode of frequent GORD, most often by their doctor's prescription treatment (68%), less often by self-treatment or a medication recommended by the pharmacist or both (17%). The prescription treatment was most often used alone (61%) and only rarely combined with self-treatment or a pharmacist's recommendation (7%). Two thirds of the subjects had used a single medication, and one-third a combination of drugs. Single medications were mainly proton-pump inhibitors (PPIs) (45%) and antacids/alginates (46%). Combinations were essentially made up of PPIs (83%), most often combined with antacids/alginates (61%). Two-thirds of subjects reported that they were entirely satisfied with their treatment, but symptoms had persisted in 24% of treated subjects.

Discussion: Prevalence of frequent GERD increases with age. Sex, obesity, and consumption of tobacco and alcoholic beverages do not appear to affect it markedly. The proportion of subjects with frequent GERD with no regular medical follow-up and resorting to self-treatment is substantial. Only two thirds are totally satisfied with their treatment.

Conclusion: Nearly 3.5 million French adult subjects currently suffer from frequent GERD, and many do not - or wait unduly to - see a doctor, despite symptom frequency. Better management of frequent GERD in France remains desirable in order to improve symptom relief and surveillance of possible complications.