Gastroenterology

Diagnosis, Treatment, and Management of GERD

Gastroesophageal reflux disease is one of the most common diagnoses made in gastroenterology, with an estimated prevalence of 8% to 33% worldwide.

In her session at Practical Updates in Primary Care 2021, Damanpreet K. Grewal, MD, discussed the diagnosis, treatment, and management of acid reflux disease. Dr Grewal is a diplomat of the American Board of Obesity Medicine and clinical assistant professor of medicine at Stanford University School of Medicine.

She began her presentation with a case study of a 36-year-old woman with a history of chronic heartburn and new-onset dysphagia symptoms, asking what the next steps in treatment should be. She went on to discuss the distinctions between gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD), including condition characteristics, strategies for diagnosis, and assessment of clinical severity.

Next, she examined 4 primary GERD phenotypes, including GERD, nonerosive reflux disease (NERD), reflux hypersensitivity, and functional heartburn.

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Following this, she discussed current guidelines for the diagnosis and management of GERD, and treatment options.

“Lifestyle changes are some of the most common things that are recommended,” including “avoiding eating too close to bedtime, elevating the head of the bed, weight loss, avoiding foods that cause symptoms, and PPI trials, specifically 8 weeks, is recommended.”

She listed various H2 blockers and PPIs, as well as patient characteristics that can predict the efficacy of PPI treatment, and went on to examine endoscopic and surgical therapy options as well.

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She closed her presentation by returning to the case study once again, discussing the final diagnosis and treatment plan.

—Michael Potts

Reference:

Grewal DK. Gastroesophageal reflux disease. Talk presented at: Practical Updates in Primary Care 2021 Virtual Series; July 17-19, 2021; Virtual.