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Gastroesophageal Reflux Disease

Tae K Kim, MD, Gemma Kim, MD and Luis A Vera, MD Reviewed 05/2023
 


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, reviewed in the prevention section above. 
  • Step-wise approach to therapy

    • Phase I: lifestyle and diet modifications, antacids plus...

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
 Maret-Ouda J, Markar SR, Lagergren J. Gastroesophageal Reflux Disease: A Review. JAMA. 2020;324(24):2536-2547. doi: 10.1001/jama.2020.21360. PMID: 33351048.
2
Katz PO, Dunbar KB, Schnoll-Su...

ADDITIONAL READING

  • Jameson JL, Fauci AS, Kasper DL, Hauser SL, et al. Harrison's Principle of Internal Medicine. 21th ed. McGraw-Hill; 2022: 2429-2430.

  • Newberry C, Lynch...

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

  • True diagnosis can be accomplished with a combination of endoscopy, biopsy and pH monitoring.

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

  • PPIs provide the most rapid ...

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