GERD Outlook: A Gastroenterologist’s Perspective

The clinical and phenotypic complexity of GERD requires a detailed, multimodality diagnostic evaluation prior to decision-making for pharmacological, endoscopic, or surgical therapies. An individualized selection has to be based on symptoms, clinical presentation, proper disease definition, therapeutic objectives, and available local endoscopic and surgical expertise. As these novel endoscopic and laparoscopic technologies evolve and mature and long-term data becomes available, decision-making will remain in flux but best done at multidisciplinary esophageal centers of excellence.