EXPLORING THE PATHOPHYSIOLOGY AND TREATMENT STRATEGIES FOR GASTROESOPHAGEAL REFLUX DISEASE: BEYOND ACID CONTROL

Gastroesophageal reflux disease (GERD) is a complex condition characterized by the backward flow of refluxate into the esophagus. Despite its prevalence and frequent clinical diagnosis, the pathogenesis of GERD is multifaceted. Many patients continue to experience persistent symptoms of GERD even after extended treatment with proton pump inhibitors (PPIs) for acid suppression. The development of GERD involves a dynamic interaction of chemical, mechanical, psychological, and neurological factors, all of which influence symptom manifestation, diagnosis, and treatment approaches. Consequently, GERD should be considered a condition that extends beyond simple acid reflux. This review will explore the key contributors to GERD pathogenesis, including aspects related to the refluxate, esophageal defense mechanisms, and factors that facilitate pathological reflux into the esophagus. Additionally, this paper will discuss recent therapeutic advancements and highlight potential future research directions in the management of GERD.