Current concept of gastroesophageal reflux disease: a review

Gastroesophageal reflux disease remains one of the most pressing issues in modern gastroenterology due to its high prevalence, chronic course, and risk of severe complications, including Barrett esophagus. This review summarizes research published between 2014 and 2024 in international (PubMed, Web of Science) and Russian (Russian Science Citation Index) scientific databases addressing epidemiology, pathophysiology, and treatment of gastroesophageal reflux disease. Epidemiological data demonstrate a global increase in disease burden—from 442 million cases in 1990 to 784 million in 2019—with marked regional variability (from 2.5% in China to 45.4% in the Middle East). In the Russian Federation, gastroesophageal reflux disease prevalence reaches 25.6%, with the highest rates observed in individuals older than 50 years. Key risk factors include abdominal obesity, tobacco smoking, and use of nonsteroidal anti-inflammatory drugs. Management of gastroesophageal reflux disease includes both non-pharmacologic approaches (lifestyle modification, diet therapy, breathing exercises) and pharmacotherapy. Proton pump inhibitors remain the standard of care; however, their long-term use is associated with risk of adverse effects. Promising areas include combination regimens incorporating antacids, alginates, esophagoprotective agents, and novel potassium-competitive acid blockers, which demonstrate advantages in treatment of resistant gastroesophageal reflux disease. Special attention is given to non-pharmacologic treatment strategies. Optimization of pharmaceutical counseling remains an important challenge aimed at minimizing self-medication and improving treatment adherence. The findings underscore the need to develop personalized therapeutic strategies considering clinical heterogeneity of gastroesophageal reflux disease, as well as the incorporation of innovative methods into clinical practice. Review results confirm the importance of a multidisciplinary approach to reduce healthcare system burden and improve patient quality of life.