GERD in Canada

As in most Western countries, management of gastroesophageal reflux disease (GERD) remains a considerable health challenge. The exact definition of GERD may differ from nation to nation and such differences in description may influence how patients are described and characterized. In Canada, symptoms of GERD are often considered as a component of dyspepsia, which can encompass a complex of upper gastrointestinal symptoms including not only reflux, but also belching, bloating, and early satiety. Many Canadian patients present with multiple and overlapping symptom complexes including GERD. An argument for an inclusive definition includes the fact that acid suppression therapy works to control symptoms of GERD and in many patients, dyspepsia. Approximately 29% of the Canadian population (∼7 million individuals) is reported to suffer from dyspepsia. Dyspepsia negatively impacts quality of life in many of these patients. The Canadian political system is comprised of a federal government and also provincial and territorial governments. Administration of healthcare is controlled by provincial governments and access to investigations and medications varies between jurisdictions across the country. While treatment guidelines for GERD have been published in Canada, the size of the country, the disparate healthcare systems, and the variance in the availability of investigations and therapies between provinces pose a significant challenge to the uniform dissemination and application of these guidelines.