Current medical and surgical treatment options for gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is one of the most common disorders in medicine. The options of medical versus surgical therapies have been highlighted by more potent acid suppression medications and by the introduction of minimally invasive surgery for GERD. Many factors will impact on the treatment selection for each individual patient: the underlying pathophysiology, typical vs atypical symptoms, presence of reflux complications, and success and limitations of medical and surgical treatments. Medical antireflux therapy is very effective and safe, but long-term maintenance therapy is required for most patients. Minimally invasive antireflux surgery has provided excellent results, but outcome is dependent on patient selection and surgical expertise. Careful pre-operative evaluation is essential to determine the optimal treatment and surgical approach.