Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the recurrent and troublesome heartburn and regurgitation of acidic stomach contents into the esophagus. Complications include Barrett esophagus, peptic stricture, esophagitis, and gastric adenocarcinoma. It is caused by dysfunction of the esophagogastric junction barrier. GERD has been estimated to occur in 15% to 25% of the population of high-income countries. This condition may be diagnosed in association with classic symptoms or following recognition of GERD-related complications.
Esophageal Symptoms
Symptoms of GERD may be limited to the esophagus and GI tract (typical GERD) and/or may be extra-esophageal
Extra-esophageal symptoms
Will occur with or rarely without typical GERD symptoms | Silent GERD is an unlikely diagnosis
Note: Although alcohol consumption is associated with upper GI symptoms, it is not considered a risk factor specifically for GERD | There are many overlapping symptoms between GERD, esophagitis and gastritis
Lifestyle modification
Medications
Proton Pump Inhibitors (PPIs)
Note: If patient requires maintenance therapy, use PPIss at lowest dose to control symptoms and maintain healing
Note: Patients who need the PPI daily but are afraid of possible side effects should be advised about the dangers of NOT taking the PPI
Other Medications
Gastroesophageal Reflux Disease: A Review
ACG Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease
AGA Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors: Expert Review
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