Gastroesophageal reflux disease in Adult
Alerts and Notices
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.
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
K21.00 – Gastro-esophageal reflux disease with esophagitis, without bleeding
K21.9 – Gastro-esophageal reflux disease without esophagitis
SNOMEDCT:
235595009 – Gastroesophageal reflux disease
Look For
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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.
- Peptic ulcer disease
- Gastritis
- Coronary artery disease
- Esophagitis
- Achalasia (see esophageal motility disorder)
- Esophageal web / esophageal ring
- Esophageal spasm (see esophageal motility disorder)
- Gastroparesis
- Hiatal hernia
- Gastroenteritis
- Malignancy (particularly esophageal, gastric, small bowel, pancreatic)
- Biliary colic / cholelithiasis
- Zollinger-Ellison syndrome
- Chronic pancreatitis
- Drug side effects (NSAIDs, alcohol, caffeine, antibiotics, corticosteroids, opiates, digoxin)
- Irritable bowel syndrome
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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