Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach contents, often due to incompetence of the lower esophageal sphincter, causes troublesome symptoms or complications. Symptoms most typically include heartburn and regurgitation. GERD is one of the most common gastrointestinal disorders seen by both primary care physicians and gastroenterologists, occurring in about 10%-20% of the Western world. Development of GERD is highly associated with being overweight or obese. Other risk factors include age older than 50 years, cigarette smoking, NSAID use, female sex, and low socioeconomic status.
For patients presenting with typical symptoms of regurgitation or heartburn, a diagnosis of GERD can be presumptively made and treated empirically. If dysphagia, atypical chest pain, chronic cough, odynophagia, or emesis are reported, further investigation is required before empiric treatment is recommended, as an underlying motility disorder, structural abnormality, or malignancy may be present.
Codes
ICD10CM: K21.00 – Gastro-esophageal reflux disease with esophagitis, without bleeding K21.9 – Gastro-esophageal reflux disease without esophagitis
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Gastroesophageal reflux disease (GERD) is a digestive disease. Patients with GERD experience stomach acid or stomach content moving up into the esophagus. This can be caused by malfunction of the esophageal sphincter, the opening between the stomach and the esophagus.
Most people manage the symptoms on their own. However, sometimes medication or surgery is needed to reduce symptoms.
Who’s At Risk
Some risk factors for GERD are:
Obesity
Pregnancy
Dry mouth
Smoking
Diabetes
Asthma
Signs & Symptoms
The symptoms of GERD are:
Heartburn or burning sensation in the chest
Difficulty swallowing
Indigestion or regurgitation of sour liquid (acid reflux)
Chest pain, sometimes wheezing
Dry cough, especially long-term cough
Sore throat
Self-Care Guidelines
The following guidelines should be followed if you have GERD:
Avoid consuming foods and drinks that give you heartburn, called trigger foods, such as coffee, alcohol, spicy or acidic foods (citrus juice, tomato products), fatty foods, chocolate, peppermint, and onion
Eat smaller meals
Refrain from lying down until 3 hours after a meal
Elevate your head in bed at least 8 inches
Refrain from smoking
Maintain a healthy weight
When to Seek Medical Care
If you experience severe symptoms of GERD, make an appointment with your health care provider.
Treatments
The following over-the-counter medicines can help treat heartburn:
Antacids such as Maalox or Mylanta can provide quick relief
Medication to reduce acid production including cimetidine (Tagamet HB) and famotidine (Pepcid AC) provide relief for up to 12 hours
Lansoprazole (Prevacid 24 HR) is a proton-pump inhibitor that blocks acid production and allows the esophagus to heal
If GERD continues despite these medications, contact your health care provider to see if stronger medication is a solution.
Prescription strength H-2 receptor blockers such as cimetidine (Tagamet) or famotidine (Pepcid)
Prescription strength proton-pump inhibitors such as esomeprazole (Nexium) or Iansoprazole (Prevacid) are well tolerated but long-term use can result in fractures and vitamin B12 deficiency
Baclofen can decrease the occurrence of gastric reflux but has side effects of lethargy and confusion
Patient Information for Gastroesophageal reflux disease in Adult