IntroductionGastroesophageal reflux disease (GERD) is probably one of the most prevalent
diseases in the world that also compromises the quality of life of the affected
significantly. Its incidence in Brazil is 12%, corresponding to 20 million
individuals.ObjectiveTo update the GERD management and the new trends on diagnosis and treatment,
reviewing the international and Brazilian experience on it.MethodThe literature review was based on papers published on Medline/Pubmed, SciELO,
Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal
reflux disease, diagnosis, clinical treatment, surgery, fundoplication.ResultsVarious factors are involved on GERD physiopathology, the most important being the
transient lower esophageal sphincter relaxation. Clinical manifestations are
heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness
and throat clearing (atypical symptoms), which may be followed or not by typical
symptoms. GERD patients may present complications such as peptic stenosis,
hemorrhage, and Barrett's esophagus, which is the most important predisposing
factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and
the symptoms must be evaluated in terms of duration, intensity, frequency,
triggering and relief factors, pattern of evolution and impact on the patient's
quality of life. The diagnosis requires confirmation with different exams. The
goal of the clinical treatment is to relieve the symptoms and surgical treatment
is indicated for patients who require continued drug use, with intolerance to
prolonged clinical treatment and with GERD complications.ConclusionGERD is a major digestive health problem and affect 12% of Brazilian people. The
anamnesis is fundamental for the diagnosis of GERD, with special analysis of the
typical and atypical symptoms (duration, intensity, frequency, triggering and
relief factors, evolution and impact on the life quality). High digestive
endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The
clinical treatment is useful in controlling the symptoms; however, the great
problem is keeping the patients asymptomatic over time. Surgical treatment is
indicated for patients who required continued drug use, intolerant to the drugs
and with complicated forms of GERD.