Last reviewed: September 2018
Last updated: May  2018

Summary

Definition

History and exam

Key diagnostic factors

  • heartburn
  • acid regurgitation

Other diagnostic factors

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

Risk factors

  • FHx of heartburn or GERD
  • older age
  • hiatal hernia
  • obesity
  • lower esophageal sphincter (LES) tone-reducing drugs
  • psychological stress
  • asthma
  • NSAIDs
  • smoking
  • alcohol consumption
  • dietary factors

Diagnostic investigations

1st investigations to order

  • proton-pump inhibitor trial
Full details

Investigations to consider

  • esophagogastroduodenoscopy (EGD)
  • ambulatory pH monitoring
  • esophageal manometry
  • combined impedance-pH testing
  • barium swallow
  • esophageal 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 has been a speaker for Synergy Pharmaceuticals and for Allergan Pharmaceuticals. He is an author of a reference cited in this monograph.

Medical Director of Gastrointestinal Endoscopy

Assistant Professor of Medicine

Division of Gastroenterology

Texas Tech University Health Sciences Center

El Paso

TX

Disclosures

AFC declares that he has no competing interests.

Dr Marc J. Zuckerman and Dr Andres F. Carrion would like to gratefully acknowledge Dr. Sheila Feit and Dr. Mohamed Othman, previous contributors to this topic. SF declares that she has no competing interests. MO has acted as a consultant for Olympus.

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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