Gastroesophageal reflux disease: risk factors, current possibilities of diagnosis and treatment optimisation

Gastroesophageal reflux disease (GERD) is one of the most common causes health care seeking at primary level in many countries. At an epidemiological level, GERD has been shown to be associated with a number risk factors: obesity, tobacco smoking, alcohol abuse, certain patterns eating behaviour, and use several medications. now regarded as heterogeneous includes different phenotypes (erosive disease, non-erosive hypersensitive oesophagus, functional heartburn), proper diagnosis which improves effectiveness therapy patients heartburn symptoms. Daily impedance–pH monitoring known integral part diagnostic algorithm for method record all types refluxes entering oesophagus regardless pH, assess their association symptoms, determine whether symptoms belong particular phenotype. Esophageal manometry plays key role evaluation it helps rule out other conditions that may mimic GERD: achalasia cardia scleroderma esophagus. This technique used thoracic esophageal motility sphincter function assessment prior antireflux surgery or refractory course GERD. The article describes detail factors (triggers well aspects, taking into account differentiated approach based on daily data accordance current guidelines recommendations.