The medical management of gastro-oesophageal reflux

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Abstract
Gastro-oesophageal reflux is a common relapsing condition caused by repeated exposure of the lower oesophagus to refluxed gastric contents. It presents in various ways: some patients just have symptoms, some have endoscopic evidence of mucosal damage (oesophagitis), with or without symptoms, and an important minority have complications such as bleeding, stricture or columnar epithelial (Barrett's) transformation of the lower oesophageal mucosa which predisposes to adenocarcinoma. Treatment aims firstly to control symptoms; it is not known to prevent any complication but when a complication occurs, treatment can aim to arrest its progress. In this article we review the medical management of gastro-oesophageal reflux in adults.