Run the List Outpatient Evaluation of GERD
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Aug 28, 2024 Dr. Navin Kumar, a gastroenterologist from Brigham and Women's Hospital, teams up with Dr. Emily Gutowski, a rheumatology fellow at NYU. They dive deep into gastroesophageal reflux disease (GERD), discussing crucial diagnosis techniques and the importance of recognizing alarm symptoms. The pair sheds light on the underlying anatomy and mechanisms of GERD, including the role of the lower esophageal sphincter. Dietary influences and treatment strategies are also examined, offering insightful advice for effective management.
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GERD Is A Clinical Diagnosis
- GERD is primarily a clinical diagnosis based on heartburn or regurgitation.
- Tissue injury or symptoms arise from reflux of gastric contents, not just acid.
Atypical Symptoms Need Broader Evaluation
- Atypical GERD presentations cluster into cardiac, pulmonary, and ENT buckets like chest pain, chronic cough, globus, and water brash.
- Atypical symptoms alone are insufficient to diagnose GERD without excluding other causes.
Screen For Alarm Symptoms
- Ask about alarm symptoms: age ≥60 with new symptoms, dysphagia, odynophagia, GI bleeding, weight loss, persistent vomiting, or family history of upper GI malignancy.
- If any alarm features exist, refer for upper endoscopy for further evaluation.