Treatment

This section describes up-to-date recommended strategies for the management of GORD, from lifestyle modifications to pharmacotherapy and surgery.

Current guidelines issued by some national bodies (NICE, the BSG, and the AGA) are included for reference.

As GORD is a chronic and prevalent disease (estimated to affect up to 60% of the UK population at some point in their lives) and is associated with a high tendency to relapse, a long-term management strategy is required in most patients. Despite its high prevalence, only a small proportion of people ever consult their doctor.

The number of people seeking medical advice for GORD can be schematically represented with the ‘iceberg concept’ (Figure 1).[Kitchin & Castell, 1991]

Iceberg representation of severity of GORD symptoms FIGURE 1 – Iceberg representation of
severity of GORD symptoms
(click to enlarge)

The majority of patients, represented by the submerged portion of the iceberg, suffer from mild or sporadic symptoms only and self-medicate rather than seek medical advice. A smaller number of patients, who experience frequent symptoms without complications, are represented by the middle portion of the iceberg, and are likely to seek medical help. The tip of the iceberg represents <10% of the population who experience chronic symptoms, which may be associated with some significant complications.

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