OBJECTIVES: GERD is one of the most common gastrointestinal disorders. Knowledge on epidemiologic data, treatment guidelines and patterns and economic details is limited. METHODS: Extensive desktop research was conducted for North America, Western and Eastern Europe and Australia using MEDLINE, EMBASE and Cochrane databases (1995-2004), telephone interviews, Internet searches (2000-2004). For structured search all MESH terms applying to GERD, epidemiologic data, treatment patterns, costs and related issues (22 in total) were used. RESULTS: Extensive review of obtained literature revealed 162 articles and other sources of information (websites, telephone contacts) for further evaluation. Prevalence of weekly GERD symptoms ranges from 4% (Canada) to 20% (USA). Population-based prevalence data are lacking for Austria, Germany and Eastern European countries. General recommendations for management of GERD consist of symptom-oriented measures with lifestyle changes and administration of antacids, Proton-Pump-Inhibitors (PPI) or H2-Receptor-Antagonists. Specific guidelines with recommendations on drug treatment exist in all countries except most of Eastern Europe. Treatment patterns widely follow guidelines with variations in drug dosage and administration period. Peer-reviewed literature revealed 20 cost-of-illness studies (16 USA, 1 Canada, 3 Western Europe, 0 Eastern Europe and Australia). In North America total direct cost (TDC) ranged from €360-€800/a (Canada €700/a). Western European cost-of-illness studies exist only for Sweden (TDC €930/a) and Italy (TDC €300/a). From third party payers' perspective main cost drivers are medication (about 40%) and outpatient care (about 60%). CONCLUSIONS: Although prevalence of GERD is high, only few studies focus on its economic burden, most of them conducted in the USA. Treatment guidelines show comparatively uniform features in all investigated countries, especially concerning the recommendation of PPI usage. Treatment patterns show wide usage of PPI, except in Eastern Europe where treatment patterns assumably resemble those in Western Europe, probably with limitations due to the countries' health care systems' possibilities.