Difficult Problems and Strategy on Diagnosis and Treatment of Gastroesophageal Reflux Disease / 胃肠病学

ABSTRACT

Gastroesophageal reflux disease(GERD)is a chronic and recurrent disease with a wide variety of symptoms,often overlapping with functional gastrointestinal disorders,having different response to proton pump inhibitor (PPI)therapy,and facing various challenging for diagnosis and treatment. It is important for improving the diagnosis via knowing well the clinical manifestations of GERD and related diseases,rational using PPI test,upper gastrointestinal endoscopy and ambulatory esophageal pH/impedance monitoring,and understanding the relationship between the symptoms and reflux events. Different strategies of maintenance therapy should be chosen in accordance with patient's condition for decreasing recurrence. Aggressive acid suppressive therapy,inhibiting gastroesophageal reflux and modulating esophageal hypersensitivity are the main treatment methods for patients with poor response to PPI after ruling out the non-GERD causes.