Peter Bánovčin jr., Juraj Halička, Rudolf Hyrdel
The gastroesophageal reflux disease (GERD) ranks among the most common diseases in gastroenterology. The incidence of GERD has been increasing in developed countries. In addition, there is also an increase of complications resulting from GERD, such as Barrett oesophagus and oesophageal adenocarcinoma. Considering the global growing trend and the identification of increasing number of extraesophageal GERD complications, GERD is again becoming the focus of attention not only of research centres. The major progress in GERD has been in the area of diagnostic methods. Using novel diagnostic methods, we are discovering that the GERD patients are a very heterogeneous group from the ethiopathogenetic and clinical point of view. The proton pump inhibitors /PPI/ have been the first choice therapy for over two decades. Despite many advantages, PPI do not treat the underlying cause of GERD. Despite the PPI therapy, a group of patients remain symptomatic, while the PPI just change the characteristic of the refluxate in these patients. The options for management of such patients are quite limited due to the limited options of pharmacotherapy. Stratification of patients based on the mechanisms underlying GERD would be the first step towards the targeted treatment.