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Gastroesophageal Reflux Disease

Adriana S. Sanchez, MD and Fozia Akhtar Ali, MD Reviewed 06/2020
 


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.

  • A...

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.
2
Sigterman KE, van Pinxteren B, Bonis PA, et al. Short-term tre...

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.

  • Kellerman R, Kintanar T. G...

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 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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