A significant percentage of people with gastro-oesophageal reflux disease (GERD) fail to improve with proton pump inhibitor (PPI) therapy. In this group of patients, refractory symptoms may be the result of non-acid reflux (NAR). Treatment of NAR ranges from simple reassurance to antireflux surgery. Current treatment algorithms include a combination of dietary and lifestyle modifications, antiacid medication, inhibition of transient lower oesophageal sphincter relaxations, and/or enhancement of the antireflux barrier. Because of the nonspecific nature of patient symptoms and the frequently elusive diagnosis, it is essential to exhaust conservative treatment options before resorting to surgical intervention. The purpose of this manuscript is to review the contemporary nonsurgical management of NAR.
ASJC Scopus subject areas
- Pharmacology (medical)