. Author manuscript; available in PMC: 2022 Dec 26.

Published in final edited form as: Ann N Y Acad Sci. 2020 Oct 4;1486(1):3–14. doi: 10.1111/nyas.14501

Table 1.

Current and future diagnostic tools and therapy for GERD personalized to mechanistic factor

Factors in GERD development		Diagnostic tool	Treatment option
Refluxate composition	Acid	Ambulatory reflux monitoring	Proton pump inhibitor H₂ receptor antagonist Potassium competitive acid blockers
	Bile	Bilitec	Bile acid sequestrant
	Pepsin	Salivary pepsin	Alginates
Esophageal defenses	Reduced integrity of the esophageal epithelium	Dilated intracellular space on biopsy Mucosal impedance/integrity	Alginates
	Heightened nociception via neuronal afferents		Pharmacologic neuromodulators Esophageal-directed hypnotherapy Cognitive behavioral therapy
	Reduced esophageal clearance	High-resolution manometry with impedance Multichannel intraluminal impedance and pH monitoring (MII-pH) Barium esophagram	Prokinetic agents
	Reversed gastroesophageal gradient	Esophageal manometry Barium esophagram	GABA agonist Surgical fundoplication Transoral incisionless fundoplication Magnetic sphincter augmentation

Note: Italics represent novel options and/or opportunities for future investigation.