Medical, surgical, and endoscopic treatment of gastroesophageal reflux disease and Barrett's esophagus

Over the past decade, medical and surgical approaches to the patient with gastroesophageal reflux disease (GERD) have improved dramatically. Proton pump inhibitors have become the dominant medical therapy because of their high efficacy and safety. Laparoscopic surgical approaches have improved concomitantly with the advances in medical therapy, resulting in the perception that either continuous medical therapy or surgery are appropriate options for long-term maintenance of this chronic disorder. Recent approval of new endoscopic treatments, for GERD has generated considerable interests but acceptance of these techniques should be limited by the small number of patients studied to date, the lack of placebo controls, and the short duration of follow-up.