Gastro-oesophageal reflux disease (GERD) is a common disorder in adults and children. The global prevalence of GERD is high and increasing. Non-erosive reflux disease is the most common phenotype of GERD. Heartburn and regurgitation are considered classic symptoms but GERD may present with various atypical and extra-oesophageal manifestations. The pathophysiology of GERD is multifactorial and different mechanisms may result in GERD symptoms, including gastric composition and motility, anti-reflux barrier, refluxate characteristics, clearance mechanisms, mucosal integrity and symptom perception. In clinical practice, the diagnosis of GERD is commonly established on the basis of response to anti-reflux treatment; however, a more accurate diagnosis requires testing that includes upper gastrointestinal tract endoscopy and reflux monitoring. New techniques and new reflux testing parameters help to better phenotype the condition. In children, the diagnosis of GERD is primarily based on history and physical examination and treatment vary with age. Treatment in adults includes a combination of lifestyle modifications with pharmacological, endoscopic or surgical intervention. In refractory GERD, optimization of proton-pump inhibitor treatment should be attempted before a series of diagnostic tests to assess the patient’s phenotype.

胃食管反流病 (GERD) 是成人和儿童的常见疾病。GERD 的全球患病率很高，而且还在不断增加。非糜烂性反流病是 GERD 最常见的表型。胃灼热和反流被认为是典型的症状，但 GERD 可能会出现各种非典型和食管外表现。GERD 的病理生理是多因素的，不同的机制可能导致 GERD 症状，包括胃组成和运动、抗反流屏障、反流特征、清除机制、粘膜完整性和症状感知。在临床实践中，GERD的诊断通常建立在抗反流治疗反应的基础上；然而，更准确的诊断需要包括上消化道内窥镜检查和反流监测在内的测试。新技术和新的回流测试参数有助于更好地对病情进行表型分析。在儿童中，GERD 的诊断主要基于病史和体格检查，治疗方法随年龄而异。成人治疗包括生活方式改变与药物、内窥镜或手术干预的组合。在难治性 GERD 中，应在一系列诊断测试之前尝试优化质子泵抑制剂治疗，以评估患者的表型。