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Gastroesophageal Reflux Disease

Fozia Akhtar Ali, MD, Anna Cecilia S. Tenorio, MD and Adriana S. Sanchez, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Changes of the esophageal mucosa resulting from reflux of gastric contents into the esophagus

  • Often described as “heartburn,” “acid indigestion,” and “acid reflux”

EPIDEMIOLOGY

Incidence

DIAGNOSIS

HISTORY

  • Typical symptoms: acid regurgitation, heartburn, dysphagia (mostly postprandial)

  • Atypical symptoms: epigastric fullness/pressure/pain, dyspepsia, nausea, bloating, belching, chest pain...

TREATMENT

GENERAL MEASURES

Lifestyle changes are first-line intervention: 
  • Elevate head of bed (2)[B].

  • Avoid meals 2 to 3 hours before bedtime (2)[B].

  • Avoid stooping, bending, and tight-fitting garments.

  • A...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Track symptoms over time.

  • Repeat endoscopy in 4 to 8 weeks if there is a poor symptomatic response to medical therapy, especially in older patien...

REFERENCES

1
1 Lee YY, McColl KE. Pathophysiology of gastroesophageal reflux disease. Best Pract Res Clin Gastroenterol.  2013;27(3):339–351. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 Ka...

ADDITIONAL READING

  • Anderson WDIII, Strayer SM, Mull SR. Common questions about the management of gastroesophageal reflux disease. Am Fam Physician.  2015;91(10):692–697. {L-End} {L-End} [View ...

SEE ALSO

Algorithms: Abdominal Pain, Upper; Dyspepsia 

CODES

ICD10

  • K21.9 Gastro-esophageal reflux disease without esophagitis

  • K21.0 Gastro-esophageal reflux disease with esophagitis

ICD9

  • 530.81 Esophageal reflux

  • 530.11 Reflux esophagitis

SNOMED

  • 235595009 Gastroe...

CLINICAL PEARLS

  • GERD is primarily a historical diagnosis.

  • Consider GERD in nonsmokers who have a chronic cough (>3 weeks).

  • Antisecretory therapy is the mainstay of pharmacotherapy for GERD.

  • PPIs provi...

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