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Gastroesophageal reflux disease in Adult
Other Resources UpToDate PubMed

Gastroesophageal reflux disease in Adult

Contributors: Michael W. Winter MD, Christine Osborne MD
Other Resources UpToDate PubMed

Synopsis

Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach contents, often due to incompetence of the lower esophageal sphincter, causes troublesome symptoms or complications. Symptoms most typically include heartburn and regurgitation. GERD is one of the most common gastrointestinal disorders seen by both primary care physicians and gastroenterologists, occurring in about 10%-20% of the Western world. Development of GERD is highly associated with being overweight or obese. Other risk factors include age older than 50 years, cigarette smoking, NSAID use, female sex, and low socioeconomic status.

For patients presenting with typical symptoms of regurgitation or heartburn, a diagnosis of GERD can be presumptively made and treated empirically. If dysphagia, atypical chest pain, chronic cough, odynophagia, or emesis are reported, further investigation is required before empiric treatment is recommended, as an underlying motility disorder, structural abnormality, or malignancy may be present.

Codes

ICD10CM:
K21.00 – Gastro-esophageal reflux disease with esophagitis, without bleeding
K21.9 – Gastro-esophageal reflux disease without esophagitis

SNOMEDCT:
235595009 – Gastroesophageal reflux disease

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

A detailed history will help delineate many of these from one another.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:10/10/2022
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Patient Information for Gastroesophageal reflux disease in Adult
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Contributors: Medical staff writer

Overview

Gastroesophageal reflux disease (GERD) is a digestive disease. Patients with GERD experience stomach acid or stomach content moving up into the esophagus. This can be caused by malfunction of the esophageal sphincter, the opening between the stomach and the esophagus.

Most people manage the symptoms on their own. However, sometimes medication or surgery is needed to reduce symptoms.

Who’s At Risk

Some risk factors for GERD are:
  • Obesity
  • Pregnancy
  • Dry mouth
  • Smoking
  • Diabetes
  • Asthma

Signs & Symptoms

The symptoms of GERD are:
  • Heartburn or burning sensation in the chest
  • Difficulty swallowing
  • Indigestion or regurgitation of sour liquid (acid reflux)
  • Chest pain, sometimes wheezing
  • Dry cough, especially long-term cough
  • Sore throat

Self-Care Guidelines

The following guidelines should be followed if you have GERD:
  • Avoid consuming foods and drinks that give you heartburn, called trigger foods, such as coffee, alcohol, spicy or acidic foods (citrus juice, tomato products), fatty foods, chocolate, peppermint, and onion
  • Eat smaller meals
  • Refrain from lying down until 3 hours after a meal
  • Elevate your head in bed at least 8 inches
  • Refrain from smoking
  • Maintain a healthy weight

When to Seek Medical Care

If you experience severe symptoms of GERD, make an appointment with your health care provider.

Treatments

The following over-the-counter medicines can help treat heartburn:
  • Antacids such as Maalox or Mylanta can provide quick relief
  • Medication to reduce acid production including cimetidine (Tagamet HB) and famotidine (Pepcid AC) provide relief for up to 12 hours
  • Lansoprazole (Prevacid 24 HR) is a proton-pump inhibitor that blocks acid production and allows the esophagus to heal
If GERD continues despite these medications, contact your health care provider to see if stronger medication is a solution.
  • Prescription strength H-2 receptor blockers such as cimetidine (Tagamet) or famotidine (Pepcid)
  • Prescription strength proton-pump inhibitors such as esomeprazole (Nexium) or Iansoprazole (Prevacid) are well tolerated but long-term use can result in fractures and vitamin B12 deficiency
  • Baclofen can decrease the occurrence of gastric reflux but has side effects of lethargy and confusion
If medication provides no relief to the symptoms of gastroesophageal reflux disease, surgery to either strengthen or reinforce the lower esophageal sphincter is an option your health care provider might recommend.
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Gastroesophageal reflux disease in Adult
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A medical illustration showing key findings of Gastroesophageal reflux disease : Epigastric pain, Hoarseness, Globus sensation, Dysphagia, Dyspepsia, Dry cough
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