THERAPEUTIC OPTIONS IN THE MANAGEMENT OF GASTROESOPHAGEAL REFLUX DISEASE

The treatment of gastroesophageal reflux disease requires an individua lized approach, and aims to remove the symptoms, to heal the esophagit is, and to prevent the recurrence or complications. These objectives a re obtained reducing the incidence of the damaging reflux: into the es ophagus by improving the antireflux barrier, decreasing the gastric ac id component, enhancing the esophageal clearance. Depending on the sev erity of the disease, gastroesophageal reflux disease may be managed t hrough a combination of lifestyle modifications, antacid-anti-refluxan t drugs, prokinetic drugs, receptor-H2- antagonists, proton pump inhib itors or surgery. Antireflux surgery should be considered in several s ituations. All patients, especially at a young age, who have an insuff icient response to medical management, presenting with a mechanically defective lower esophageal sphincter or with various grades of complic ations are candidates for surgery. Although a surgery is rarely used a s treatment option in patients affected by gastroesophageal reflux dis ease, the percentage of success is upper to 80-90 %, especially after the introduction of minimally invasive procedures, with significantly ad vitam reduced costs.