Mortality risk of gastroesophageal reflux disease
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All-Cause Mortality Risk in Gastroesophageal Reflux Disease (GERD)
Large population-based studies show that GERD does not significantly increase all-cause mortality. In a Swedish twin cohort, individuals with GERD had no higher risk of death from any cause or from cancer compared to those without GERD, even after adjusting for factors like heredity, smoking, and comorbidities . Similarly, while some UK cohort studies found a slightly higher risk of death (1.16- to 1.6-fold) in people with GERD, most of these deaths were due to cardiac disease rather than GERD itself Becher2008Solaymani-Dodaran2005. Overall, the absolute risk of death directly caused by GERD is very low Becher2008Richter2017Katzka2020.
GERD and Esophageal Cancer Mortality
GERD is a known risk factor for esophageal adenocarcinoma (EAC), and people with GERD have a higher risk of dying from this cancer compared to those without GERD Ness-Jensen2020Solaymani-Dodaran2005. However, the absolute number of deaths from EAC among GERD patients remains low. For example, in the Swedish twin study, the EAC-specific mortality rate was 0.45 per 1,000 person-years in those with GERD, compared to 0.22 in those without GERD . In population-based UK data, less than half of the excess mortality in GERD and Barrett’s esophagus cohorts could be attributed to esophageal cancer .
Mortality from Non-Malignant GERD Complications
Deaths from non-malignant complications of GERD, such as esophageal erosions, ulcers, bleeding, perforation, and strictures, are rare but do occur. Data from the USA, UK, and Finland show that GERD and its non-malignant complications cause a small number of deaths each year, with age and male sex increasing the risk . Mortality from these complications has been slowly increasing over time, but the overall numbers remain very low .
GERD and Sepsis-Related Mortality
Recent genetic studies suggest that GERD may increase the risk of sepsis and sepsis-related 28-day mortality. Mendelian randomization analyses found that people with a genetic predisposition to GERD had a higher risk of developing sepsis and dying from it within 28 days Zhou2024Fu2025. Some of this risk may be mediated by changes in gut bacteria associated with GERD . However, these studies do not prove that GERD itself directly causes sepsis or sepsis-related death, and more research is needed Zhou2024Fu2025.
GERD and Cardiovascular Disease Mortality
GERD is associated with an increased risk of several cardiovascular diseases, including coronary artery disease, myocardial infarction, atrial fibrillation, heart failure, and stroke Gries2023Sun2022. Some studies suggest that GERD and its treatments may contribute to cardiovascular risk, but the direct impact of GERD on cardiovascular mortality is still unclear Gries2023Sun2022. Most deaths in GERD patients are due to cardiac causes rather than GERD itself Becher2008Solaymani-Dodaran2005.
Summary and Conclusion
In summary, GERD rarely causes death directly. The overall risk of dying from GERD or its non-malignant complications is very low. GERD does increase the risk of esophageal adenocarcinoma, but the absolute number of cancer deaths among GERD patients is small. There is some evidence that GERD may increase the risk of sepsis and cardiovascular diseases, but most deaths in GERD patients are due to other causes, especially heart disease. For most people, GERD is a chronic condition that causes discomfort and complications, but not a significant increase in mortality risk.
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