Chronic GERD - Strategies to relieve symptoms and manage complications

Gastroesophageal reflux disease (GERD) is a common chronic disease in the o lder population. Because of the cumulative effects of acid reflux over many years, older patients with GERD are at increased risk of complications suc h as esophagitis, peptic strictures, and Barrett's esophagus. Early endosco py is indicated for all older patients with GERD, irrespective of their sym ptoms. Medical and surgical treatment options for GERD and its complication s can provide excellent symptom relief and healing of esophagitis. Three ma nagement approaches-step up, step down, and the directed approach-are recog nized guides to clinical decision-making.