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JAMA Surg. 2016 Jan;151(1):73-8. doi: 10.1001/jamasurg.2015.4233.

An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease.

Author information

1
Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois.

Abstract

IMPORTANCE:

Gastroesophageal reflux disease (GERD) is prevalent worldwide, particularly in developed countries. It is estimated that the prevalence of GERD in the United States is approximately 20% and that it is increasing because of the epidemic of obesity.

OBJECTIVE:

To review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of GERD.

EVIDENCE REVIEW:

A search of PubMed was conducted for the years spanning 1985 to 2015 and included the following terms: heartburn, regurgitation, dysphagia, gastroesophageal reflux disease, cough, aspiration, laryngitis, GERD, GORD, endoscopy, manometry, pH monitoring, proton pump inhibitors, open fundoplication, and laparoscopic fundoplication. Only articles in English were included.

FINDINGS:

Lifestyle modifications, proton pump inhibitors, and laparoscopic fundoplication are proven treatment modalities for GERD. Endoscopic procedures have not been proven as effective. A Roux-en-Y gastric bypass is the procedure of choice when GERD and morbid obesity coexist.

CONCLUSIONS AND RELEVANCE:

Gastroesophageal reflux disease is a highly prevalent disease. Once the diagnosis has been established, the best results are obtained by a multidisciplinary team with the goal of individualizing treatment for patients.

PMID:
26629969
DOI:
10.1001/jamasurg.2015.4233
[Indexed for MEDLINE]

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