[Gastro-oesophageal reflux disease--a common and benign but costly disease]

The prevalence of GORD has increased. GORD causes significant impairment of the quality of life and is the most costly gastrointestinal disease. In patients aged under 55 years and without alarming symptoms and signs, treatment may be started without endoscopy. Proton pump inhibitors are the most effective medical treatment. Most GORD patients have normal oesophageal findings on endoscopy. If medical treatment fails, the diagnosis of GORD should be verified. The indications for surgical treatment, i.e. laparoscopic fundoplication, include the failure of medical treatment, severe erosive esophagitis, regurgitation as the main symptom, and severe GORD with large hiatal hernia.