What Should be the Approach in the Long-term Management of Patients with Gastroesophageal Reflux Disease?

Abstract

Objective: The aim of this study is to review available treatment options and to review current opinions in the management of patients with chronic gastroesophageal reflux disease (GERD). Materials and methods: This is a review article. Articles for the literature review were collected by using Google Search Scholar Engine. Literature search included relevant original and review articles addressing issues like medical treatment for GERD, surgical treatment for GERD, studies comparing surgical and medical treatment for GERD. GERD is a common and chronic syndrome. Patients affected with syndrome experience symptoms which affect their quality of life. The goals of treatment in this condition is to control symptoms, heal injured esophageal mucosa and to prevent complications. Both proton pump inhibitor (PPI) therapy and antireflux surgery are equally effective in controlling symptoms and in healing esophageal mucosal injury. In the recent years, laparoscopic surgery is increasingly been offered to patients with GERD. However, there is still controversy over best approach to management of GERD. This study attempted to review current opinions of this issue. Conclusion: PPIs is an option for initial management of GERD. However, this condition been a chronic condition, relapse is common while on therapy with medications or following discontinuation of therapy. Hence, a treatment option which provides effective control of symptoms and prevents or minimizes complications has to be offered to patients. Medical therapy with PPI and laparoscopic antireflux surgery, both can achieve these therapeutic goals. Hence, in the light of this literature review it is recommended to individualize the treatment offered to the patient with GERD, in consultation with the patient himself or herself.