[Gastroesophageal reflux disease: Candidates and indications to surgical treatment].

INTRODUCTION

Always, when the gastric juice gets into the esophagus, it produces changes in it. What brings the attention in this fact is that there can be no changes in the mucosa in spite of the reflux. The lost of co-relation with the clinic symptoms have created confusion in the patients evaluations. The gastroesophageal reflux disease is the result of a multifactor process in which esophagus and stomach are involved.

OBJECTIVE

To know the indications for the surgical treatment.

BACKGROUND

What has been the evolution on the management of the gastroesophageal reflux disease? In the first half of the twentieth century, the treatment was medical. In the fifty's, R. Nissen designed the anti-reflux surgery. The introduction of the proton pump inhibitors substantially improved the illness control with medications. The laparoscopic surgery appears, and the short time of recovery increased the interest on this therapeutic way. The availability of the ambulatory pH monitoring improved the possibility to recognize gastroesophageal reflux disease. The medical treatment has the advantage of been conservative and it can be lead to modify the cause and the effect. The surgical treatment can correct the anatomic defects, but does not resolve the acid secretion in most of the surgical techniques. In conclusion, there is no evidence to advocate medical or surgical therapy as the best therapy for gastroesophageal disease. As everything in medicine, the final decision on the gastroesophageal reflux disease must be individualized.