Key points in the management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a relatively common condition with a prevalence ranging from 10% to 20% in Western countries and 5% to 10% in Asian populations [1]. In a recent evidence-based consensus [2], GERD was defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms or complications. This global definition emphasizes the syndromic nature of the disease and subdivides the patients in different groups depending on the presence of mucosal complications (ie, esophagitis, metaplasia, stenosis) and on the prevalent clinical manifestations (ie, typical reflux symptoms or extraesophageal/supraesophageal syndromes). General practitioners, gastroenterologists, and specialists from different branches of medicine generally share the management of GERD patients, and basically they need to address the following four issues.