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Gastrointestinal reflux disease (GERD) is the most prevalent gastrointestinal disorder in the United States with considerable morbidity. It is typically characterized by the classic symptoms of heartburn and regurgitation. The management of GERD includes assessment for alarm features which should prompt further investigation. However, in most cases GERD is a presumptive diagnosis that can be treated empirically with proton pump inhibitor (PPI) therapy without extensive diagnostic evaluation. This chapter will review the non-operative management of GERD, including medical therapy as well as the additional diagnostic for patients at risk for complications of GERD.

Gastroesophageal reflux disease (GERD) is the most common disorder of the esophagus and the most common reason for gastroenterology consultation. Pharmacotherapy with proton pump inhibitors and histamine receptor antagonists has revolutionized the treatment of GERD and is able to yield symptomatic relief in the majority of compliant patients. However, many patients have incomplete or unsatisfactory responses to maximal medical management due to a number of factors, including hypersensitivity, volume or bile refluxate, poor compliance, and the inability of pharmacotherapy to address the underlying anatomic and neuromuscular deficits responsible for GERD. Laparoscopic Nissen fundoplication remains the gold standard for invasive therapy for GERD. This chapter will discuss existing and evolving endoscopic treatments for GERD and the available evidence to support their use.