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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2026; 32(7): 116425
Published online Feb 21, 2026. doi: 10.3748/wjg.v32.i7.116425
Published online Feb 21, 2026. doi: 10.3748/wjg.v32.i7.116425
Beyond monotherapy by acid suppression: Reshaping the management of refractory gastroesophageal reflux disease
Xin-Ye Zuo, Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Qian-Qian Chen, Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Zuo XY contributed to the statistical analysis and writing of the original manuscript; Chen QQ contributed to the conceptualization and supervision of the manuscript. Both of the authors approved the final version to publish.
Supported by General Program of Municipal Natural Science Foundation of Beijing, No. 7232151.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qian-Qian Chen, MD, Professor, Department of Gastroenterology and Hepatology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. qian_qian_chen@163.com
Received: November 11, 2025
Revised: December 11, 2025
Accepted: December 25, 2025
Published online: February 21, 2026
Processing time: 87 Days and 8.4 Hours
Revised: December 11, 2025
Accepted: December 25, 2025
Published online: February 21, 2026
Processing time: 87 Days and 8.4 Hours
Core Tip
Core Tip: A recent Shanghai study identified prolonged disease duration and anxiety as key risk factors for refractory gastroesophageal reflux disease, whereas moderate physical activity is protective. Management should extend beyond standard acid suppression to include a “multidimensional” strategy incorporating anti-anxiety interventions, exercise prescriptions, and multidisciplinary collaboration. However, the study’s single-region sample and cross-sectional design necessitate future multi-regional, long-term research to validate and establish causality.