Overview: initial and long-term management of gastro-oesophageal reflux disease

Initial management of gastro-oesophageal reflux disease aims to confirm a symptom-based diagnosis, to relieve symptoms, to reassure the patient as to the treatable nature of reflux disease, and to initiate risk management and healing of oesophagitis. The aims of long-term management include adequate control of symptoms, prevention of complications, and improvement of quality of life. Management options in terms of use of proton pump inhibitors are either daily therapy (maintenance), intermittent courses of therapy (for example, 4 weeks, then cease and observe), or on-demand therapy. This overview discusses the advantages and disadvantages of these different strategies for the management of reflux disease.