Community issues in gastroesophageal reflux disease: what we know and what we do not know

GERD is one of the most common disorders seen by physicians. Despite its wide prevalence, the impact of this disorder on patients and the community remains unclear. A more precise understanding of the impact of GERD on the community will require vigorous studies to determine if aggressive diagnosis and therapy improve clinical outcomes and decrease the cost of the disease to the community. In addition, the issue of screening and surveillance endoscopy for patients with long-standing GERD or Barrett's esophagus must be evaluated in terms of the ability to decrease esophageal cancer mortality and costs. Comparisons with similar diseases, such as asthma and breast cancer, may provide clues to the answers to these questions but are not a substitute for rigorous clinical trials.