Gastroesophageal reflux disease

Area of Science:

• Gastroenterology
• Internal Medicine

Background:

• Gastroesophageal reflux disease (GERD) is a prevalent chronic gastrointestinal disorder with increasing incidence in Asia.
• Typical GERD symptoms include heartburn and regurgitation, but diagnosis remains challenging due to a lack of standard criteria and limitations in diagnostic studies like 24-h pH monitoring, particularly for non-erosive reflux disease (NERD).
• Elderly patients often exhibit atypical GERD manifestations and may experience more severe disease progression.

Purpose of the Study:

• To review the diagnostic challenges and therapeutic strategies for GERD, focusing on its increasing prevalence and management in various patient populations.
• To highlight the role of proton pump inhibitors (PPIs) as both a diagnostic tool and a primary treatment for GERD.
• To discuss surgical intervention as an alternative for patients seeking to discontinue long-term PPI therapy.

Main Methods:

• Literature review of diagnostic and therapeutic approaches for GERD.
• Analysis of the efficacy and limitations of current diagnostic methods, including PPI trials.
• Examination of treatment modalities, including pharmacotherapy (PPIs) and surgical options.

Main Results:

• Proton pump inhibitors (PPIs) are widely used as a short-term diagnostic test and are the mainstay treatment for GERD.
• Diagnostic studies for GERD, including 24-h pH monitoring, have limitations in sensitivity, especially for NERD.
• Elderly patients present unique challenges in GERD diagnosis and management due to atypical symptoms and disease severity.

Conclusions:

• Effective diagnosis and management of GERD are crucial, given its increasing prevalence and the limitations of current diagnostic tools.
• PPIs are essential for both diagnosis and treatment, but surgical options should be considered for select patients.
• Further research may be needed to improve diagnostic accuracy and tailor treatment strategies for diverse GERD patient groups, particularly the elderly.