The latest treatments for gastroesophageal reflux disease (GERD) in 2024: Medications and surgery

disease (GERD) is one of the most common health challenges of our time, directly impacting the quality of life of millions worldwide. With rapid medical advancements, managing this condition is no longer limited to temporary relief; recent years have witnessed significant leaps in treatment protocols, ranging from sophisticated medications to minimally invasive surgical interventions.

In this regard, Dr. Tarek El-Shaarawy , a consultant in gastroenterology and hepatology, confirmed that gastroesophageal reflux disease (GERD ) occurs as a result of a functional disorder that allows stomach acid to flow back up, causing unpleasant symptoms that can worsen if neglected. He noted that treatment options have diversified considerably to suit different cases.

Historical context and development of treatment

Historically, treatment for gastroesophageal reflux disease (GERD) relied primarily on simple antacids and dietary modifications. However, with the discovery of proton pump inhibitors (PPIs) in the late 1980s, there was a radical shift in symptom management. Today, we live in an era of precision medicine and minimally invasive interventions that aim to correct anatomical defects rather than simply alleviate pain.

First line of treatment: Modern medications

Dr. El-Shaarawy explained that medication remains the cornerstone of treatment, specifically proton pump inhibitors (PPIs) . Generations of these drugs have evolved to become more effective and safer, especially when used under medical supervision for mild to moderate cases, as they significantly reduce acid secretion, giving the esophagus a chance to recover.

Endoscopic and minimally invasive techniques

For patients who do not respond to medication or wish to avoid traditional surgery, the consultant reviewed promising options:

• “STRETTA” technology: It uses radiofrequency waves to strengthen the esophageal sphincter muscle without surgical incision.
• Magnetic sphincter (MSA): An advanced technology in which a flexible ring is placed around the sphincter muscle, allowing food and preventing acid reflux, and it is removable.
• TIF technique: A procedure performed orally to fold the fundus of the stomach and repair the esophageal valve without external surgery.

Surgery: The gold standard and dual solutions

In advanced cases, Dr. El Shaarawy emphasized that Nissen fundoplication remains the gold standard globally, offering a radical solution with minimal surgical intervention. He also noted that morbidly obese patients with reflux may benefit doubly from gastric bypass surgery (RYGB) , which treats obesity, reflux, and hiatal hernia simultaneously.

A future outlook and the importance of lifestyle

The conversation turned to the future, where promising studies are underway on the use of low-energy lasers and biological therapies to reduce esophageal inflammation, as well as the move towards gene-based “personalized medicine.”.

Despite all this technological advancement, Dr. El-Shaarawy emphasized in his concluding remarks that lifestyle remains the crucial element in the therapeutic equation. His golden advice includes:

• Raise the head of the bed by 15-20 cm while sleeping.
• Avoid heavy meals right before bedtime.
• Reduce stimulants such as coffee, chocolate, and smoking.
• Weight loss is a necessary step for obese patients.

Neglecting to treat gastroesophageal reflux disease not only affects daily comfort, but may also lead to serious complications such as Barrett's esophagus; therefore, accurate diagnosis and choosing the appropriate treatment based on the patient's condition is the way to a full recovery.