Published in:
05-10-2024 | Gastroesophageal Reflux Disease
Emerging Diagnostic Tools and Medical Management of GERD
Published in: Current Treatment Options in Gastroenterology | Issue 4/2024
Login to get accessAbstract
Purpose of Review
Gastroesophageal reflux disease (GERD) remains one of the most common conditions seen by gastroenterologists, with variable practices regarding diagnostic workup, empiric treatment, and type and duration of medical management.
There are multiple new advancements in the multimodal approach to behavioral and lifestyle management as well as novel medications that will likely change the current paradigm.
The purpose of this review is to discuss these emerging medical and interventional treatment options, provide the latest evidence-based data and personal insights into current practices.
This summary will address GERD. We will not specifically address disorders of gut brain interaction, and other esophageal pathologies such as eosinophilic esophagitis and achalasia.
Recent Findings
Increased evidence and expert consensus have emerged related to procedural intervention for patients not responding to proton-pump inhibitors (PPI), with updated recommendations regarding laparoscopic fundoplication for those with a large hiatal hernia, magnetic sphincter augmentation for regurgitation-predominant symptoms, and transoral incisionless fundoplication in selected patients with mild GERD and a small hiatal hernia. Potassium-Competitive Acid Blockers (PCABs) are now available. Recent data demonstrate potential advantages compared to PPIs and will clearly augment our options for medical treatment of GERD patients.
Summary
We provide updated treatment options for the management of GERD, highlighting the most recent advancements in approaching minimally invasive procedural interventions, which patients are best suited for these procedures, insight on appropriate medication use, and discussion of the role of the recently approved PCAB medication.
