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Gastroesophageal Reflux Disease

Sarah Burroughs, DO Reviewed 06/2022
 


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 (1)[B].

  • Avoid meals 2 to 3 hours before bedtime (1)[B].

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Monitor symptoms over time. Consider additional workup and/or treatment if symptoms fail to improve after 8 weeks of PPI treatment.

  • Repeat endosc...

REFERENCES

1
Patti  MG. An evidence-based approach to the treatment of gastroesophageal reflux disease. JAMA Surg.  2016;151(1):73–78. [View Abstract on OvidMedline] ...

ADDITIONAL READING

  • Alimi Y, Azagury DE. Gastroesophageal Reflux Disease and the Patient with Obesity. Gastroenterol Clin North Am. 2021 Dec;50(4):859-870. 

  • Kel...

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

SNOMED

  • 235595009 Gastroesophageal reflux disease (disorder)

  • 266433003 Gastroes...

CLINICAL PEARLS

  • GERD is diagnosed primarily by an accurate medical history.

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

  • PPIs provide the most rapid symptomatic relief and healing of ...

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