Many patients with reflux symptoms can be managed from the clinical history and appropriate first-line therapy. Alarm features such as dysphagia, bleeding, weight loss or anaemia—and symptoms that persist despite treatment—may require deeper evaluation.
Gastroscopy can show oesophagitis, Barrett’s oesophagus or structural disease, but a normal endoscopy does not always exclude reflux. In selected patients, pH or impedance-pH monitoring can assess the relationship between symptoms and reflux events. Manometry may be important when surgery or an endoscopic anti-reflux procedure is considered.
TIF, GERD-X and other endoscopic approaches are not standard treatments for everyone. Hiatal hernia size, motility, objective reflux evidence, body weight and response to previous treatment influence selection.
The aim is not to choose the newest procedure, but to define the reflux mechanism and match treatment to the individual patient.
Gastroscopy can show oesophagitis, Barrett’s oesophagus or structural disease, but a normal endoscopy does not always exclude reflux. In selected patients, pH or impedance-pH monitoring can assess the relationship between symptoms and reflux events. Manometry may be important when surgery or an endoscopic anti-reflux procedure is considered.
TIF, GERD-X and other endoscopic approaches are not standard treatments for everyone. Hiatal hernia size, motility, objective reflux evidence, body weight and response to previous treatment influence selection.
The aim is not to choose the newest procedure, but to define the reflux mechanism and match treatment to the individual patient.
