Gastroesophageal Reflux Disease
Topic overview
Two experienced surgeons discuss the clinical management of gastroesophageal reflux disease, covering diagnostic approaches, medical versus surgical treatment options, and patient selection for antireflux procedures. This educational dialogue provides practical insights for surgeons managing GERD patients.
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Key takeaways
- GERD diagnosis requires correlation of symptoms with objective findings on endoscopy, pH monitoring, or impedance testing
- PPI therapy remains first-line medical management, but failure should prompt investigation for alternative diagnoses
- Surgical fundoplication is indicated for patients with documented reflux who fail medical therapy or have complications
- Preoperative manometry is essential to rule out achalasia and assess esophageal body function before antireflux surgery
- Hiatal hernia repair is a critical component of fundoplication to prevent wrap herniation and recurrent reflux
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