Current pharmacological and procedural treatments for gastro-oesophageal reflux disease: comprehensive review

Youssef, MM; Watson, AC; Profitt, SA; Allaway, M; Ongso, Y; Sivakumar, J; Kamal, AN; Shimamura, Y; Thompson, SK; Watson, DI; Duong, CP; Liu, DS

Author(s): Youssef, MM; Watson, AC; Profitt, SA; Allaway, M; Ongso, Y; Sivakumar, J; Kamal, AN; Shimamura, Y; Thompson, SK; Watson, DI; Duong, CP; Liu, DS;
Details: Publication Year 2025-10-30,Volume 9,Issue #6,Page zraf115
Journal Title: BJS Open
Publication Type: Review
Abstract: BACKGROUND: Gastro-oesophageal reflux disease (GORD) has a global prevalence of 14% and significantly impairs quality of life. Treatment for GORD is rapidly evolving due to advances in pharmacotherapy, surgical techniques, and new interventional approaches and devices. There are also ongoing refinements in patient selection for interventional therapy. This article reviews the latest developments. METHODS: An expert narrative review was conducted of the most recent literature. RESULTS: As a non-operative treatment, potassium-competitive acid blockers have emerged as an alternative to proton pump inhibitors (PPIs), receiving legislative approval in several countries, owing to their longer duration of acid suppression and higher rates of healing GORD complications. Surgically, research has continued to refine patient selection, perioperative decision-making, and intraoperative facets of laparoscopic fundoplication and hiatus hernia repair. Robotic antireflux surgery is also increasingly being performed internationally, with comparable clinical outcomes to laparoscopic approaches. Moreover, novel endoscopic techniques (antireflux mucosal ablation, antireflux mucosectomy surgery, transoral incisionless fundoplication, and the Medigus Ultrasonic Surgical Endostapler procedure) and devices (RefluxStop™ and LINX™) are being evaluated to treat GORD with varying levels of success. This review discusses the technical rationale, latest trial outcomes, potential pitfalls, and future considerations for these novel therapies. CONCLUSION: GORD is a highly prevalent disorder incurring significant morbidity. Although PPIs and laparoscopic fundoplication remain the current standards for the pharmacological and surgical treatment of GORD, novel drugs, approaches, techniques, and devices have emerged to tackle this important health issue. Their future utility will need to be proven against the current standards of care, and their success will enable personalized treatment for patients with GORD.
Publisher: Oxford University Press
Keywords: Humans; *Gastroesophageal Reflux/therapy/drug therapy/surgery; *Fundoplication/methods; Proton Pump Inhibitors/therapeutic use; Laparoscopy/methods; Robotic Surgical Procedures/methods; Quality of Life; Linx™; RefluxStop™; antireflux mucosal ablation; magnetic sphincter augmentation; robotic antireflux surgery; transoral incisionless fundoplication
Department(s): Surgical Oncology
Publisher's Version: https://doi.org/10.1093/bjsopen/zraf115
Open Access at Publisher's Site: https://doi.org/10.1093/bjsopen/zraf115
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-01-15 02:19:24

Last Modified: 2026-01-15 02:19:31