Definition, epidemiology, and risk factors of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a chronic disorder characterized by the abnormal backflow of gastric contents into the esophagus, causing typical symptoms such as heartburn and regurgitation, as well as extraesophageal manifestations. Its global prevalence is estimated at 13.98%, with significant regional variations. In Mexico, studies such as SIGAME report a high symptom frequency, with at least one weekly episode in 12.1% of the population. Established risk factors include obesity, hiatal hernia, pregnancy, high-fat diets, smoking, and the use of drugs that reduce lower esophageal sphincter pressure. Anatomical and functional conditions, such as delayed gastric emptying, also contribute to disease development. Diagnosis is primarily clinical, confirmed, when necessary, by endoscopy and pH monitoring, incorporating current concepts such as the “actionable” GERD definition from the Lyon Consensus 2.0, which emphasizes both clinical correlation and objective reflux evidence. Management includes lifestyle modifications, pharmacologic therapy –primarily proton pump inhibitors– and, in selected cases, antireflux surgery. Emerging therapies and considerations in special populations, such as pregnant, where drug safety is a priority, are also discussed. GERD remains a clinical challenge due to its high prevalence, impact on quality of life, and potential for complications. Timely diagnosis and individualized treatment are essential for optimal outcomes. Future research should focus on specific subpopulations and the evaluation of novel therapeutic approaches based on updated diagnostic criteria.