Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • heartburn
  • acid regurgitation

Other diagnostic factors

  • dysphagia
  • bloating/early satiety
  • laryngitis
  • globus
  • enamel erosion
  • halitosis

Risk factors

  • FHx of heartburn or GORD
  • older age
  • hiatus hernia
  • obesity
  • lower oesophageal sphincter (LOS) tone-reducing drugs
  • psychological stress
  • asthma
  • NSAIDs
  • smoking
  • alcohol consumption
  • dietary factors

Diagnostic investigations

1st investigations to order

  • proton-pump inhibitor (PPI) trial
Full details

Investigations to consider

  • oesophagogastroduodenoscopy (OGD)
  • ambulatory pH monitoring
  • oesophageal manometry
  • combined impedance-pH testing
  • barium swallow
  • oesophageal capsule endoscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Chief of Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

MJZ declares that he has no competing interests. He is an author of a reference cited in this monograph.

Assistant Professor of Medicine

Gastroenterology and Hepatology Section

Department of Internal Medicine

Baylor College of Medicine

Houston

TX

Disclosures

MO has acted as a consultant for Olympus.

Dr Marc J. Zuckerman and Dr Mohamed Othman would like to gratefully acknowledge Dr Sheila Feit, a previous contributor to this monograph. SF is an employee of BMJ.

Peer reviewers VIEW ALL

Professor of Medicine

Chief of GI Endoscopy

Rikshospitalet University Hospital

Oslo

Norway

Disclosures

LA declares that he has no competing interests.

Consultant

Department of Internal Medicine

Copenhagen University Hospital

Hellerup

Denmark

Disclosures

LLG declares that she has no competing interests.

Professor of Medicine

Department of Gastroenterology & Hepatology

Center for Swallowing & Esophageal Disorders

Cleveland Clinic

Cleveland

OH

Disclosures

GWF has received fees from: Astra Zeneca (consultant, speakers bureau, grant support); Takeda (grant support); Pentax (speaker, travel); Wyeth (consultant); and C2 Therapeutics (consultant).

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