Gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) includes different manifestations of esophageal and extraesophageal affections, such as erosive reflux disease, Barrett's esophagus, laryngitis and even pulmonary diseases. Typical symptoms are heartburn and acid regurgitation, but there are a lot of atypical disturbances like hoarseness or chronic cough. Endoscopy is the most important diagnostic procedure for elderly patients and for those with atypical symptoms. Younger people without alarming symptoms can be tested for GERD by treatment with proton pump inhibitors (PPI). The therapeutic approach depends on the endoscopic findings. PPI are preferred drugs to manage most GERD-related problems. Anti reflux surgery is appropriate for selected patients. Long-term followup data will help to define the benefit of new endoscopic procedures. Barrett's esophagus has to be regarded as a precancerous lesion, therefore surveillance strategy is required.