Detecting and Handling Refractory GERD: The Schemas at Work, Vono, gastro, Gastroenterology, Gastroenterologist, FH: Functional heartburn; GERD: Gastroesophageal reflux disease; G-POEM: Gastric peroral endoscopic myotomy; H2RA: Histamine H2 receptor antagonist’ LA: Los Angeles classification; PCAB: Potassium competitive acid blocker; PPI: Proton pump inhibitor; RH: Reflux hypersensitivity; RSA: Reflux symptom association, VONOprazan.
Diagnosing refractory GERD involves distinguishing between proven and unproven GERD to guide the investigative and therapeutic approach, as illustrated in Figure 1.1
Figure 1: Algorithm for evaluation and management of esophageal symptoms suspicious for reflux disease.1
Management strategies for refractory GERD should begin with lifestyle modifications and optimization of antisecretory therapy as elucidated in Figure 2.1
Figure 2: Algorithm for evaluation and management of esophageal symptoms suspicious for reflux disease.1
FH: Functional heartburn; GERD: Gastroesophageal reflux disease; G-POEM: Gastric peroral endoscopic myotomy; H2RA: Histamine H2 receptor antagonist’ LA: Los Angeles classification; PCAB: Potassium competitive acid blocker; PPI: Proton pump inhibitor; RH: Reflux hypersensitivity; RSA: Reflux symptom association.
1. Davis TA, Gyawali CP. Refractory gastroesophageal reflux disease: Diagnosis and management. J Neurogastroenterol Motil. 2024;30(1):17–28.
LMRC Code: GGI-CO-A1-AQS-300041558-APPEMC-H24-1493 DOI of 25/08/2024 & DOE of 30/11/2024
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