The many manifestations of gastroesophageal reflux disease: presentation, evaluation, and treatment.
Gastroesophageal reflux disease (GERD) is a common problem that is expensive to diagnose and treat. The disease is increasing in prevalence in the Western world, with important risk factors being obesity and the eradication of Helicobacter pylori. Heartburn and acid regurgitation are classic symptoms of GERD, but their sensitivity is poor. Ambulatory esophageal pH testing is the most sensitive test for GERD, whereas endoscopy is the most specific test. Medical treatment with proton pump inhibitors (PPIs) has revolutionized the treatment of GERD and its complications, but long-term side effects do exist. Laparoscopic anti-reflux surgery and PPIs have similar efficacy in the few available long-term trials. This article reviews the presentation, evaluation, and treatment of GERD.
Richter
Joel E
JE
The Richard L. Evans Chair, Department of Medicine, Temple University School of Medicine, 3401 North Broad Street, 801 Parkinson Pavilion, Philadelphia, PA 19140, USA. jrichter@temple.edu
D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D050782:Esophageal pH Monitoring; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014943:Global Health; D006801:Humans; D008365:Manometry; D009017:Morbidity / Q000639:trends; D011312:Pressure; D011379:Prognosis; D054328:Proton Pump Inhibitors; D012307:Risk Factors
D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors