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Gastroesophageal Reflux Disease, Emergency Medicine

Yanina Purim-Shem- Tov Reviewed 06/2017
 


Basics

Description

  • Spectrum of pathology in which gastric reflux causes symptoms and damage to esophageal mucosa

  • Reflux esophagitis vs. nonerosive reflux disease

  • 40% of general population experience symp...

Diagnosis

Signs and Symptoms

  • Esophageal manifestations

    • Heartburn (or pyrosis)

    • Regurgitation

    • Dysphagia

  • Extraesophageal manifestations

    • Bronchospasm

    • Laryngitis

    • Chronic cough

History

  • Typical signs and symptoms:

    • Hear...

Treatment

Pre-Hospital

  • Esophageal pain may mimic angina

  • Airway may need active control secondary to vomiting

Initial Stabilization/Therapy

  • ABCs need to be evaluated

  • IV fluid resuscitation for blood loss or...

Follow-Up

Disposition

Admission Criteria

  • Significant esophageal bleeding

  • Uncontrolled reactive asthma

  • Dehydration

  • Starvation and failure to thrive

Discharge Criteria

Uncomplicated GERD: Refer to patient's pr...

Pearls and Pitfalls

  • GERD therapy should include lifestyle changes.

  • In patients with worse than mild and intermittent GERD symptoms initiate acid-suppressive therapy.

  • In patients with GERD and moderate t...

Additional Reading

  • Cappell  MS. Clinical presentation, diagnosis, and management of gastroesophageal reflux disease. Med Clin North Am.  2005;89(2):243–291.

  • DeVault  KR, Castell  DO, American Coll...

Codes

ICD9

  • 530.11 Reflux esophagitis

  • 530.81 Esophageal reflux

ICD10

  • K21 Gastro-esophageal reflux disease

  • K21.0 Gastro-esophageal reflux disease with esophagitis

  • K21.9 Gastro-esophageal reflux disease withou...

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