Gastro-oesophageal reflux disease

Area of Science:

• Gastroenterology
• Digestive Health

Background:

• Gastro-oesophageal reflux disease (GERD) is a prevalent and growing global health concern affecting both adults and children.
• Non-erosive reflux disease represents the most frequent GERD subtype, often presenting with atypical or extra-oesophageal symptoms beyond classic heartburn and regurgitation.

Purpose of the Study:

• To review the multifactorial pathophysiology of GERD, encompassing gastric factors, anti-reflux mechanisms, and symptom perception.
• To discuss current diagnostic approaches, including empirical treatment response, endoscopy, and advanced reflux monitoring for precise phenotyping.
• To outline age-specific diagnostic and treatment strategies for GERD in children and adults, including refractory cases.

Main Methods:

• Literature review of GERD pathophysiology, diagnosis, and treatment modalities.
• Analysis of diagnostic tools such as upper gastrointestinal endoscopy and reflux monitoring.
• Examination of treatment options including lifestyle changes, pharmacotherapy, and surgical interventions.

Main Results:

• GERD pathophysiology involves complex interactions of gastric function, anti-reflux barriers, and refluxate clearance.
• Accurate diagnosis relies on a combination of clinical presentation, endoscopic evaluation, and reflux testing for phenotyping.
• Treatment is tailored to age and severity, with optimization of proton-pump inhibitor therapy recommended for refractory GERD.

Conclusions:

• Effective GERD management requires understanding its diverse pathophysiology and employing accurate diagnostic phenotyping.
• Personalized treatment strategies, from lifestyle modifications to advanced interventions, are crucial for managing GERD in different patient populations.
• Ongoing advancements in diagnostic techniques enhance the ability to characterize GERD phenotypes, leading to improved therapeutic outcomes.