The gastric reflux: a challenge in clinical practice

Gastric reflux, such as the spill of gastric contents outside the stomach, may become symptomatic when the refluxate damages the esophageal mucosa, such as the gastroesophageal reflux disease (GERD). The worldwide prevalence of GERD is continuously increasing in the last few years. The guidelines for diagnosing and treating GERD are well consolidated and timely updated. In addition, gastric content, even only gaseous, may spill out the esophagus, damaging other organs, mainly airways. As a result, the extra-esophageal manifestations of reflux have been considered from a multidisciplinary point of view; the symptoms of laryngopharyngeal reflux (LPR) are precisely defined as autonomous disorders. The otolaryngologists have codified guidelines for the LPR diagnosis, but the treatment is still poorly specified. Consequently, many healthcare professionals, including general practitioners, pediatricians, gastroenterologists, otolaryngologists, other medical specialists, and pharmacists, manage GERD and LPR patients. Many therapeutic options are available. The most common medications include proton pump inhibitors, alginates, and antacids.