Management of Gastroesophageal Reflux Disease

Typical symptoms for these clients include heartburn and regurgitation.  Atypical presentations include cough, asthma, hoarseness, and throat-clearing.  There may also be chronic laryngitis, chest pain, nausea, and indigestion.  Nevertheless, if atypical symptoms occur in someone who also has typical complaints, it is quite possible that he or she has GERD.  This is especially the case when a trial of proton pump inhibitors brings relief [1, 2].

In most instances, six to eight weeks of treatment with proton pump inhibitors are sufficient to make the diagnosis when it is present [1].

Further investigation, such as endoscopy, may be necessary for those who experience difficulty swallowing, weight loss, or bleeding.  Upper endoscopy becomes an indication when the client does not respond to drug therapy.  It also is necessary when complaints such as noncardiac chest pain occur or when the patient has risk factors for Barrett’s esophagus [1, 2].

Barrett’s esophagus is an abnormality in the epithelial lining of that anatomic part of the body, and it is a precursor for the development of cancer of the esophagus.  Risk factors for Barrett’s esophagus include male gender, old age, cigarette smoking, excessive body weight, and Caucasian race [1, 2].

Moreover, peptic stricture is another possibility when endoscopy has to take place [1].

There has been benefit from antireflux surgery in these more serious cases [1, 2]

In any event, it is possible to monitor the amount of acidity or basicity of the esophagus via endoscopy and pH manometry.  In fact, this approach is the gold standard as exposure of the esophageal mucosa to acid reflux may take place over many years [1, 2].

The diagnosis and management of GERD will depend upon severity of illness, but a knowledgeable medical team can manage it.

1. Alzubaidi, M. and Gabbard, S.  (2015).  GERD:  Diagnosing and treating the burn.  Cleveland Clinic Journal of Medicine, 82, 685-692.
2. National Institute of Diabetes and Digestive and Kidney Diseases.  (2014).  Acid reflux (GER and GERD) in adults.  Retrieved October 16, 2016.
3. The photo shows a library at the U.S. Centers for Disease Control and Prevention and is reprinted with permission from that organization.   

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.