Rethinking gastroesophageal reflux disorder

Ann N Y Acad Sci. 2020 Dec;1482(1):177-192. doi: 10.1111/nyas.14478. Epub 2020 Sep 1.

Abstract

Gastroesophageal reflux disease (GERD) is a common clinical condition for which our understanding has evolved over the past decades. It is now considered a cluster of phenotypes with numerous anatomical and physiological abnormalities contributing to its pathophysiology. As such, it is important to first understand the underlying mechanism of the disease process for each patient before embarking on therapeutic interventions. The aim of our paper is to highlight the mechanisms contributing to GERD and review investigations and interpretation of these results. Finally, the paper reviews the available treatment modalities for this condition, ranging from medical intervention, endoscopic options through to surgery and its various techniques.

Keywords: fundoplication; gastroesophageal reflux disease; hiatus hernia; lower esophageal sphincter.

Publication types

  • Review

MeSH terms

  • Barrett Esophagus / physiopathology
  • Esophageal Sphincter, Lower / physiopathology*
  • Esophagogastric Junction / physiopathology*
  • Esophagoscopy / methods*
  • Fundoplication / methods
  • Gastroesophageal Reflux / physiopathology*
  • Gastroesophageal Reflux / therapy*
  • Hernia, Hiatal / physiopathology
  • Humans
  • Life Style
  • Manometry / methods
  • Obesity / pathology
  • Proton Pump Inhibitors / adverse effects
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Proton Pump Inhibitors