TREATMENT OF GASTROESOPHAGEAL REFLUX DISE ASE

The natural history of gastroesophageal reflux disease is usually that of a chronic disorder. Spontaneous remission is rare, and cure even m ore so, especially in more severe cases. Treatment of esophagitis has been eased in most cases with current drugs, but recurrence is almost the rule after discontinuation of therapy. Therefore, long-term treatm ent is required in many patients. The drugs of preference for long-ter m treatment are acid inhibitors given at the lowest dose that suppress es symptoms. Surgical treatment should be reserved for the rare patien t who cannot be managed satisfactorily with conservative treatment. Be cause of the high risk of adenocarcinoma in Barret's esophagus, endosc opic surveillance of all patients with acceptable surgical risk is rec ommended.