Therapy of Gastroesophageal Reflux Disease: The Gastroenterological Approach

  • L. Okolicsanyi
  • C. Guatti-Zuliani


Gastroesophageal reflux disease (GERD), the most common disorder of the esophagus, is extremely variable in its presentations and clinical course. It is known from epidemiological studies that many people complain of typical reflux symptoms, including heartburn and regurgitation, but only few request medical investigation. About 20%–40% of the world’s population has symptoms suggestive of GERD; an exact estimate is difficult because of the way the disease presents [1]. In 1985, Castell [2] described GERD as an iceberg, with a large base indicating patients with slight and episodic symptoms without need of medical assistance, a smaller portion of patients with moderate and recurrent symptoms and, at the top, patients with severe and persistent symptoms requiring special care (Fig. 1). Furthermore, a number of patients with atypical symptoms, such as refractory asthma, recurrent hoarseness, chronic unexplained cough or non-cardiac chest pain, are later discovered as having GERD. Thus, it seems evident that this disease is frequently underdiagnosed.


Lower Esophageal Sphincter Gastroesophageal Reflux Disease Reflux Esophagitis Symptomatic Gastroesophageal Reflux Antireflux Barrier 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Italia 1999

Authors and Affiliations

  • L. Okolicsanyi
    • 1
  • C. Guatti-Zuliani
    • 1
  1. 1.Gastroenterology Section, Institute of Medical SemeiologyUniversity of ParmaItaly

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