Current Medical Management of Gastroesophageal Reflux Disease

With the widespread availability of proton pump inhibitors, most patients who have symptoms of gastroesophageal reflux receive treatment before any diagnostic tests. Fortunately, this treatment trial serves as a reasonable test itself. The vast majority of patients who have reflux can be managed adequately with medical therapy. Most patients who have symptoms refractory to therapy do not actually have reflux. Although one attempt to discontinue therapy is reasonable, typical patients who have reflux need long-term therapy. The challenge is providing the appropriate level of therapy to allow symptom control while keeping medical costs at a minimum.