Phenotypes of gastroesophageal reflux disease and personalized management

Gastroesophageal reflux disease (GERD) is characterized by troublesome symptoms that develop as a result of the backflow of gastric refluxate into the esophagus. Despite the high prevalence of this condition and significant costs associated with GERD, the paradigm of management has up until recently been oversimplified and ineffective for many patients. A personalized approach to the diagnostic evaluation and management of GERD is paramount to successful therapy and symptom relief. GERD management should account for the patient's symptoms and address the underlying pathophysiology leading to their symptoms. To aid in this personalized approach, there are several permutations of GERD that result in specific phenotypes with unique symptomology and pathophysiology. A personalized approach to GERD should begin by identifying specific GERD phenotypes. Using knowledge of specific phenotypes, we can predict response to various treatments and personalize management to increase the probability of successful GERD therapy.