Opinion Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2023; 29(5): 773-779
Published online Feb 7, 2023. doi: 10.3748/wjg.v29.i5.773
Management of gastro-esophageal reflux disease: Practice-oriented answers to clinical questions
Leonardo Frazzoni, Lorenzo Fuccio, Rocco Maurizio Zagari
Leonardo Frazzoni, Lorenzo Fuccio, Rocco Maurizio Zagari, Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna 40138, Italy
Lorenzo Fuccio, Rocco Maurizio Zagari, Department of Medical and Surgical Sciences, University of Bologna, Bologna 40138, Italy
Author contributions: Frazzoni L drafted the manuscript; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Leonardo Frazzoni, MD, Academic Fellow, Medical Assistant, Department of Digestive Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Via Albertoni 15, Bologna 40138, Italy. leonardo.frazzoni@gmail.com
Received: October 14, 2022
Peer-review started: October 14, 2022
First decision: November 3, 2022
Revised: December 1, 2022
Accepted: January 9, 2023
Article in press: January 9, 2023
Published online: February 7, 2023
Abstract

Gastro-esophageal reflux disease (GERD) is a condition which is frequently faced by primary care physicians and gastroenterologists. Improving management of GERD is crucial to maximise both patient care and resource utilization. In fact, the management of patients with GERD is complex and poses several questions to the clinician who faces them in clinical practice. For instance, many aspects should be considered, including the appropriateness of indication to endoscopy, the quality of the endoscopic examination, the use and interpretation of ambulatory reflux testing, and the choice and management of anti-reflux treatments, i.e., proton-pump inhibitors and surgery. Aim of the present review was to provide a comprehensive update on the clinical management of patients with GERD, through a literature review on the diagnosis and management of patients with GER symptoms. In details, we provide practice-oriented concise answers to clinical questions, with the aim of optimising patient management and healthcare resource use.

Keywords: Gastro-esophageal reflux disease, Diagnosis, Management, Proton-pump inhibitor

Core Tip: Gastro-esophageal reflux disease (GERD) still poses several clinical issues to be faced, from clinical and instrumental diagnosis to medical and surgical therapy. In this review we provide the most updated evidence on the management of GERD. Practice-oriented questions on GERD are answered through a concise review of current literature. The aim is to provide clinicians a practical tool to guide them through the management of patients with GERD.