When did gastro-esophageal reflux become a disease? A historical perspective on GER(D) nomenclature.

Overview

BACKGROUND: Within the span of a few decades, gastro-esophageal reflux (GER) evolved from a rare entity to the most commonly diagnosed upper gastro-intestinal disease, i.e. gastro-esophageal reflux disease (GERD). The boundaries of GERD remain matter of controversy and appear to be ever expanding in both children and adults. Our aim is to answer the questions: when did GER become a disease? And when did it become specifically a pediatric disease? METHODS: We performed a comprehensive historical review of the original medical literature using Medline and Google, along with a compilation of original and secondary texts in English, French and German. RESULTS: Our finding is that those actively involved in treating the reflux, first surgeons in the 1960s and then gastroenterologists in the 1970s, initiated naming it a disease. In pediatrics, the possible correlation between reflux events and sudden infant death syndrome accelerated the management of reflux associated with respiratory symptoms with surgery in the 1970s. Surgeons were also the first specialists to formulate the term pediatric GERD in 1982. CONCLUSION: Understanding the genesis of GERD may shed light upon its expansion as a disease category and its persistent controversial nature in pediatrics.