GERD Common Signs and symptoms seen According to the American College of Gastroenterology, GERD is symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, into the oral cavity including larynx, or lung (Katz, Gerson, & Vela, 2013). Typical symptoms are heartburn and acid regurgitation. Atypical symptoms include cough, laryngitis, asthma, or dental erosion. GERD may occur with or without esophageal inflammation. Symptoms may be without erosions on endoscopic examination, nonerosive reflux disease, or with erosions present (Zuckerman & Carrion, 2018). Screening assessment tools Many instruments have been developed to measure the health effects of GERD. Some, such as the Gastroesophageal Reflux Disease Activity Index (GRACI), the Gastrointestinal Symptom Rating Scale (GSRS), and the Gastroesophageal Reflux Questionnaire (GERQ) measure the intensity and frequency of GERD symptoms. Others, including the Quality of Life in Reflux and Dyspepsia (QOLRAD) and the GERD Health Related Quality of Life Scale (GERD- HRQL), consider not only the symptoms but also the effects of symptoms on quality of life (Lui et al., 2004). Recommended diagnostic tests (if any) Diagnosis of GERD is a clinical diagnosis. A therapeutic trial of a proton-pump inhibitor (PPI) can serve for both diagnosis and initial treatment. Upper endoscopy is indicated to evaluate for complications such as atypical, persistent, or relapsing symptoms, or for alarm features such as weight loss or anemia (Zuckerman & Carrion, 2018). Treatment plans both pharmacologic and non-pharmacologic based on current clinical practice guidelines Non-pharmacological treatments include recommending lifestyle changes. These changes include weight loss for overweight patients, smoking cessation
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