MODERN MANAGEMENT OF GERD: INTEGRATING ADVANCED DIAGNOSTICS AND INTERVENTIONAL THERAPIES

Michał Drabik; Maksym Sikora; Jakub Nowak; Michael Platschek; Klaudia Dybalska; Julia Kosmulska; Mateusz Kęska; Anna Barbara Tuleja; Sylwia Kolano; Karol Józef Szkarłat

doi:10.31435/ijitss.4(48).2025.4238

Michał Drabik 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0009-0004-0198-4926
Maksym Sikora The Hospital of the Brothers of St. John of God, Kraków, Poland https://orcid.org/0009-0008-4495-7732
Jakub Nowak Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Kraków, Kraków, Poland https://orcid.org/0009-0003-7097-0635
Michael Platschek Blessed Marta Wiecka Hospital in Bochnia, Bochnia, Poland https://orcid.org/0009-0008-9085-4531
Klaudia Dybalska Brzeziny Specialist Hospital, Brzeziny, Poland https://orcid.org/0009-0006-9900-0167
Julia Kosmulska University Hospital in Wrocław, Wrocław, Poland https://orcid.org/0009-0000-8770-3793
Mateusz Kęska 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0000-0003-0712-7613
Anna Barbara Tuleja University Hospital in Wrocław, Wrocław, Poland https://orcid.org/0009-0003-9185-9493
Sylwia Kolano Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Kraków, Kraków, Poland https://orcid.org/0009-0000-1180-1135
Karol Józef Szkarłat Medical University of Silesia in Katowice, Katowice, Poland https://orcid.org/0009-0004-2889-8382

DOI: https://doi.org/10.31435/ijitss.4(48).2025.4238

Keywords: GERD, Esophagus, Reflux, Acid, Health

Abstract

Gastroesophageal reflux disease (GERD) is a widespread gastrointestinal disorder with a significant global burden. Its multifactorial etiology is influenced by unmodifiable risk factors such as sex-based differences; men, for instance, show a higher predisposition for more severe complications like esophageal adenocarcinoma. GERDs pathophysiology is heavily connected with mechanical failure of the anti-reflux barrier, a two-component system that consists of the intrinsic lower esophageal sphincter (LES) and the extrinsic crural diaphragm. Interference in the form of hiatal hernia, hypotensive LES pressure or transient LES relaxations leads to reflux. Modern approach highlights the critical role of microscopic mucosal damage, which causes visceral hypersensitivity and allows the distinction of various phenotypes like non-erosive reflux disease and reflux hipersensitivity. Diagnosis is guided by the Lyon Consensus 2.0 using endoscopy, manometry, and impedance-pH monitoring. Treatment is a multi-step process – it includes lifestyle modification, numerous pharmacological agents such as proton pump inhibitors or newer potassium-competitive acid blockers, and, for refractory cases, interventional treatment via laparoscopic Nissen fundoplication, transoral incisionless fundoplication or magnetic sphincter augmentation.

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