Published online Jul 7, 2026. doi: 10.3748/wjg.119608
Revised: February 16, 2026
Accepted: April 1, 2026
Published online: July 7, 2026
Processing time: 150 Days and 2.4 Hours
Gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) have posed challenges in clinical practice. Previous studies have suggested that GERD frequently overlaps with FD. In recent years, successive observational studies have further highlighted the urgent clinical need to better characterize the asso
To investigate the potential link between GERD and FD by integrating the latest research evidence.
PubMed, Web of Science, EMBASE, and the Cochrane Library were comprehensively searched using Medical Subject Headings and related keywords. The risk of bias for cohort and case-control studies was assessed using the Newcastle-Ottawa Scale, and cross-sectional studies were assessed using the Agency for Healthcare Research and Quality scale; scoring was based on the content of the original studies. When statistical heterogeneity was low (Cochran’s Q P > 0.10 and I2 ≤ 50%), estimates were pooled using a fixed-effects model; otherwise (I2 > 50%), a random-effects model was applied to account for between-study variability. Potential publication bias (small-study effects) was assessed by visual inspection of funnel plots and formally tested using Egger’s regression test. All analyses were conducted in Stata (version 14.0; StataCorp, College Station, TX, United States).
This meta-analysis included 40 studies. Of these, 19 studies (n = 99194) showed a significant association between GERD and FD [odds ratio = 4.77, 95% confidence interval (CI): 3.56-6.40, P < 0.001; I2 = 96.6%]. 5 studies (n = 1655) reported a significantly higher incidence of FD in patients with non-erosive reflux disease than in those with erosive reflux disease (odds ratio = 4.50, 95%CI: 1.01-20.03, P < 0.001; I2 = 97.2%). Another 10 studies (n = 2100) reported a pooled prevalence of FD symptoms of 40% among patients with GERD (95%CI: 28.0%-53.0%, P < 0.001; I2 = 97.18%). 9 studies (n = 2945) reported a pooled prevalence of GERD symptoms of 41% among patients with FD (95%CI: 26.0%-58.0%, P < 0.001; I2 = 98.74%).
This meta-analysis suggests that GERD and FD are associated, potentially reflecting shared pathophysiological mechanisms and/or residual confounding.
Core Tip: This meta-analysis integrates the most recent evidence to clarify the relationship between gastroesophageal reflux disease (GERD) and functional dyspepsia (FD). Pooled results indicate a strong association between GERD and FD, supporting the concept that these disorders frequently overlap in clinical practice. The findings suggest that shared pathophysiological pathways may contribute to co-occurrence, although residual confounding cannot be excluded. Improved recognition of GERD-FD overlap may help optimize evaluation strategies and guide more targeted, mechanism-based management.