Introduction to Refractory Gerd

Refractory GERD patients not responding to BID proton pump inhibitors are often referred for anti-reflux surgery.

Methods: Prospective randomized study of 46 pediatric patients with refractory GERD who underwent laparoscopic Nissen fundoplication divided into two equal groups.

We aimed to assess the safety, feasibility, and efficacy of a novel endoscopic resection and plication (RAP) anti-reflux procedure for management of medically refractory GERD in patients with altered gastric anatomy.

The panel conditionally recommended surgical treatment over medical management for adults with chronic or chronic refractory GERD.

Stretta can be considered in patients with PPI refractory GERD and might have a role in patients with reflux hypersensitivity and functional heartburn.

The first indication of Stretta is refractory GERD without definite hiatal hernia or GEFV grade IV.

Research on esophageal mucosal integrity in gastro-oesophageal reflux disease (GERD) has been taken seriously in recent years, especially in refractory GERD.

Transoral incisionless fundoplication (TIF2) and magnetic sphincter augmentation (MSA) are less invasive options for the treatment of refractory GERD and are increasingly gaining popularity.

We prospectively enrolled patients undergoing upper endoscopy for refractory GERD or non-GERD conditions.

We aimed to review the outcomes of STRETTA in patients with medically refractory GERD, who had undergone previous gastric surgery.

METHODS We performed an observational study of patients with refractory GERD who underwent EGD from 2013 to 2016 at a tertiary hospital.

GOALS To update the estimate of the prevalence of refractory gastroesophageal reflux disease (GERD) in the United States, and to assess the clinical and economic differences between patients with and without refractory GERD.

Causes of acquired long-segment esophageal disruption include recurrent leaks and fistulae after primary repair, refractory GERD, caustic ingestions, cancer, and strictures.

Here, we evaluate the efficacy and acceptability of partial fundoplication for the treatment of medically refractory GERD in patients with scleroderma.

Therefore, management of refractory GERD in this population remains challenging.

Here, we investigated the potential role of RvD1 in acid-induced DNA damage in esophageal epithelial cells, patients with refractory GERD and a rat model of acid reflux.

Conclusions  Post-POEM, PPI-refractory GERD is rare.

The Dor fundoplication performed for refractory GERD in SSc patients substantially decreases heartburn and regurgitation, primarily nocturnal, without affecting dysphagia, thus improving the quality of life.

In a subsequent exploratory study, saliva was collected from 34 patients with continuing GERD symptoms despite PPI treatment (refractory GERD), 30 healthy subjects, and 30 PPI-controlled GERD patients at ≥4 hours postmeal.

We investigated the efficacy of a low FODMAPs diet in patients with PPI refractory GERD.

In refractory GERD, optimization of proton-pump inhibitor treatment should be attempted before a series of diagnostic tests to assess the patient’s phenotype.

We believe that due to bile content, alternative therapeutic strategies using specific inhibitors of relevant molecular pathways or receptors may be considered in patients with refractory GERD.

Although lifestyle and diet modification and proton-pump inhibitors (PPIs) remain the standard of therapy, approximately 30% of patients experience persistent or recurrent symptoms with this therapy, which has been labeled PPI-refractory GERD.

Noteworthy is that the majority of the alleged PPI-refractory GERD patients do not, after careful investigations, have GERD.