Gastroesophageal reflux disease (GERD) is a complex disorder. Symptoms of heartburn can help find the disorder of GERD. pH testing is the mainstay of evaluation of symptoms, including 24‐h and longer pH studies to detect pathologic acid exposure. The use of proton pump inhibitor (PPI) therapy for approved indications is helpful for both symptomatic relief and esophagitis healing in the majority of patients with abnormal acid exposure. PPI medications are safe in short‐ or long‐term use. It is recommended not to maintain cirrhotic patients on PPI therapy without a meaningful indication. Dietary adjustment can provide benefit to some patients, but the data are mixed on how much benefit has been demonstrated from specific food avoidance. Reduction in weight improves reflux. Obesity has measurable effects on the esophageal acid exposure but fewer effects on the motility of the esophagus itself. Controlling weight and changing lifestyle can be helpful for improving GERD symptoms. For some patients in whom either the control of reflux with medications and lifestyle change is not sufficient or a hernia is contributing to symptom generation, surgical and endosurgical interventions can be considered to help manage reflux after a thorough workup with pH testing and manometry.

中文翻译：

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非胃肠病学家的 GERD：成功的评估、管理和基于生活方式的症状控制

胃食管反流病 (GERD) 是一种复杂的疾病。胃灼热的症状可以帮助发现胃食管反流病。pH 值测试是评估症状的主要手段，包括 24 小时和更长时间的 pH 值研究，以检测病理性酸暴露。使用质子泵抑制剂 (PPI) 治疗批准的适应症有助于大多数酸暴露异常患者的症状缓解和食管炎愈合。PPI 药物短期或长期使用都是安全的。建议在没有有意义的适应症的情况下，不要让肝硬化患者继续接受 PPI 治疗。饮食调整可以为一些患者带来益处，但关于特定食物避免带来多少益处的数据不一。减轻体重可改善反流。肥胖对食道酸暴露有可测量的影响，但对食道本身的运动性影响较小。控制体重和改变生活方式有助于改善 GERD 症状。对于一些通过药物和生活方式改变不足以控制反流或疝气导致症状产生的患者，在通过 pH 测试和测压进行彻底检查后，可以考虑手术和内外科干预来帮助控制反流。