An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease.

Abstract

IMPORTANCE:

Gastroesophageal reflux disease (GERD) is prevalent worldwide, particularly in developed countries. It is estimated that the prevalence of GERD in the United States is approximately 20% and that it is increasing because of the epidemic of obesity.

OBJECTIVE:

To review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of GERD.

EVIDENCE REVIEW:

A search of PubMed was conducted for the years spanning 1985 to 2015 and included the following terms: heartburn, regurgitation, dysphagia, gastroesophageal reflux disease, cough, aspiration, laryngitis, GERD, GORD, endoscopy, manometry, pH monitoring, proton pump inhibitors, open fundoplication, and laparoscopic fundoplication. Only articles in English were included.

FINDINGS:

Lifestyle modifications, proton pump inhibitors, and laparoscopic fundoplication are proven treatment modalities for GERD. Endoscopic procedures have not been proven as effective. A Roux-en-Y gastric bypass is the procedure of choice when GERD and morbid obesity coexist.

CONCLUSIONS AND RELEVANCE:

Gastroesophageal reflux disease is a highly prevalent disease. Once the diagnosis has been established, the best results are obtained by a multidisciplinary team with the goal of individualizing treatment for patients.

• Authors: Marco G Patti
• Journal: JAMA surgery (JAMA Surg) Vol. 151 Issue 1 Pg. 73-8 (Jan 2016) ISSN: 2168-6262 [Electronic] United States
• PMID: 26629969 (Publication Type: Journal Article, Review)

Chemical References

• Proton Pump Inhibitors

Topics

• Endoscopy
• Esophageal pH Monitoring
• Fundoplication
• Gastric Bypass
• Gastroesophageal Reflux (complications, diagnosis, physiopathology, therapy)
• Humans
• Laparoscopy
• Life Style
• Manometry
• Obesity, Morbid (complications, surgery)
• Proton Pump Inhibitors (therapeutic use)