It usually occurs after eating a big meal or while lying down. It is a burning feeling in the lower chest, with a sour or bitter taste in the throat and mouth. For regularly updated information on a variety of health topics, please visit familydoctor. In patients with nonerosive reflux disease or symptomatic reflux esophagitis, hour pH monitoring has a sensitivity and specificity of 70 to 96 percent, but false-positive or false-negative results are possible.Please note: This information was current at the time of publication.īut medical information is always changing, and some information given here may be out of date. Acid Reflux Diet 7 Foods To Eat And To Avoid There is no gold standard for diagnosing GERD, although hour pH monitoring pH probe is the accepted standard for establishing or excluding its presence. Only 2 to 3 percent of acid reflux events reach the conscious level and are perceived by patients with GERD. If a patient has classic symptoms of heartburn and acid regurgitation, the diagnosis can be made with high specificity, yet the sensitivity remains low.

In many of these patients, reported quality of life is lower than in patients who have untreated angina pectoris or chronic heart failure.Ī careful history is essential to establish the diagnosis of GERD. Many patients self-diagnose and self-treat, and do not seek medical attention for their symptoms, while others have more severe disease, including erosive esophagitis. Gastroesophageal reflux disease GERD is a common chronic, relapsing condition that is associated with a risk of significant morbidity and the possibility of mortality from complications. Newer endoscopic modalities, including the Stretta and endocinch procedures, are less invasive and have fewer complications than antireflux surgery, but response rates are lower. Antireflux surgery, including open and laparoscopic versions of Nissen fundoplication, is an alternative treatment in patients who have chronic reflux with recalcitrant symptoms. Diagnostic testing should be reserved for patients who exhibit warning signs i. In patients with erosive esophagitis identified on endoscopy, a PPI is the initial treatment of choice. The preferred empiric approach is step-up therapy treat initially with an H2RA for eight weeks if symptoms do not improve, change to a PPI or step-down therapy treat initially with a PPI then titrate to the lowest effective medication type and dosage. In patients with reflux esophagitis, treatment is directed at acid suppression through the use of lifestyle modifications e. The primary treatment goals in patients with gastroesophageal reflux disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis, and prevention of complications of esophagitis. A more recent article on this topic is available.

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