Peer Reviewed
Feature Article Gastroenterology

Update on gastro-oesophageal reflux disease

Edmund Tse, Richard H Holloway
An updated version is available in the linked supplement
Abstract

Gastro-oesophageal reflux disease is an increasingly common problem in the community, and most patients are managed in general practice. A symptom-based diagnosis can besupported by a trial of therapy. Most patients will require long-term treatment.

Key Points
    • A careful history is the most useful method for the diagnosis of reflux disease.
    • A symptom-based diagnosis can be supported by a trial of proton pump inhibitor (PPI) therapy.
    • Endoscopic abnormalities are found in fewer than half of all patients with reflux symptoms.
    • Investigations are warranted if the diagnosis is unclear, symptoms persist despite treatment, or alarm symptoms suggest complications.
    • Initial therapy with a standard dose of a PPI is the most effective treatment.
    • Most patients will require long term treatment; intermittent, symptom-driven, on-demand treatment with PPIs is a cost effective approach in many patients.
    • In experienced hands, antireflux surgery is an effective alternative to PPI therapy in the long term management of reflux disease.
Get full access
Subscribe for full access to all articles
Buy this article

Single article purchases are temporarily unavailable due to site maintenance.

If you would like to purchase an article during this time, please email us at [email protected] with the article details and we'll assist you directly. We'll also let you know when online purchasing is available again.

Thank you for your patience and understanding.

Already a subscriber?