Discuss the methods, indications for oesophageal reflux treatment including lifestyle, medical and surgical and outline the rationale and indications for these treatments. LIFESTYLE MODIFCATIONS Dietary changes: Avoid foods and beverages that trigger reflux. E.g. fatty foods, chocolate, caffeine and alcohol. Weight management Reduces the pressure on the stomach. Elevating the head of the bed: Raising the head of the bed by 6 to 8 inches to prevent nighttime reflux. Eating habits: Eat smaller but more regular meals. RATIONALE: these helps reduce the frequency and severity of episodes by minimising factors that increase intraabdominal pressure or relax the LES. INDICATIONS: recommended for all patients with GERD as the first line treatment. Especially for patients with mild symptoms. MEDICAL MANAGEMENT Antiacids H2 receptor blockers PPIs Prokinetics RATIONALE: Reduce acid production. Neutralise existing acids and improve oesophageal motility -> reduce symptoms and prevent complications. INDICATIONS: Used for patients with moderate to severe symptoms, patients with erosive oesophagitis or those that do not respond adequately to lifestyle modifications. SURGICAL INTERVENTIONS Nissen fundoplication: The top stomach is wrapped around the LES to strengthen it and prevent reflux. LINX device: A ring of magnetic beads is placed around the LES -> augment its’ function. Endoscopic procedures: Techniques such as radiofrequency ablation to tighten the LES. RATIONALE: Aims to restore the function of the LES -> provide long term solution for patients who do not respond to medical therapy or have complications like strictures or Barrett’s oesophagus. INDICATIONS: Considered for patients with: Severe and refractory GERDC Patients who cannot tolerate medications Patients who prefer surgical solutions.