The global, regional, and national patterns of change in the burden of gastroesophageal reflux disease, 1990-2021: An analysis of the global burden of disease study 2021 and forecast to 2036

Background: Data from the Global Burden of Disease (GBD) 2019 indicate a growing global burden of gastroesophageal reflux disease (GERD), with significant variations across regions and socio-demographic index (SDI) levels. Ongoing monitoring is essential to inform prevention strategies. Methods: Using GBD 2021 data, we estimated incidence, prevalence, disability-adjusted life years (DALYs), their age-standardized rates (ASRs), and average annual percentage changes (AAPCs) for GERD from 1990 to 2021. We also evaluated health inequalities by SDI and performed Bayesian age-period-cohort (BAPC) modeling for projections. Results: Between 1990 and 2021, GERD prevalent cases, incident cases, and DALYs increased by 83.15%, 80.06%, and 82.46%, respectively. All ASRs showed a steady rises with AAPCs of 0.11 (incidence and prevalence) and 0.12 (DALYs). Age-specific trends revealed increasing ASRs in those under 50 but declines in those over 50, suggesting a shift toward younger populations. A negative correlation was observed between SDI and GERD burden across 204 countries and 21 regions. Health inequality measures (Slope Index of Inequality and Concentration Index) widened over time, indicating increasing disparities between high- and low-SDI countries. Projections suggest a continued increase in the global GERD burden through 2036. Conclusion: GERD remains a persistent public health challenge, particularly affecting younger and middle-aged populations, and low-SDI regions. Targeted resource allocation and improved disease management are urgently needed.