Current Treatment Options in Gastroenterology

, Volume 3, Issue 4, pp 295–302 | Cite as

Functional gastroesophageal reflux disease (GERD)

  • Kenneth R. DeVault
  • Sami R. Achem

Opinion statement

  • Lack of endoscopic esophagitis does not exclude gastroesophageal reflux disease (GERD).

  • Ambulatory pH testing is also an imperfect standard, and patients with both a normal endoscopy and a normal pH test may still have symptoms produced by acid reflux.

  • A therapeutic trial of acid suppression is often the best approach to these patients.

  • Ideally, therapeutic trials should use a medication with a high degree of efficacy in the treatment of GERD to avoid a false-negative test.

  • Proton pump inhibitors (PPIs) are the best currently available medical therapy for all forms of GERD.

  • If the patient does not respond to a once daily PPI, options include increasing the dose of PPIs, and, perhaps, adding another class of agent or studying the patient with an ambulatory pH test.

  • Patients with a negative endoscopy, negative pH test. and those who do not respond to an adequate trial of acid suppression are unlikely to benefit from antireflux surgery.


Irritable Bowel Syndrome Omeprazole Esophagitis Cisapride Gastroesophageal Reflux Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Current Science Inc 2000

Authors and Affiliations

  • Kenneth R. DeVault
    • 1
  • Sami R. Achem
    • 1
  1. 1.Mayo Clinic JacksonvilleJacksonvilleUSA

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