Back to Medical Hub

Gastroesophageal Reflux Disease (GERD) Protocol

Gastrointestinal

1. Assessment & Diagnosis

  • Classic Symptoms: Heartburn (burning sensation in the chest) and acid regurgitation are the most reliable symptoms for presumptive diagnosis.
  • Atypical Symptoms: Chest pain, chronic cough, asthma, or hoarseness may also be caused by reflux.
  • Empiric Therapy: A trial of Proton Pump Inhibitors (PPI) is recommended as a diagnostic test for patients with typical symptoms and no alarm features.

    • 2. Management

  • Pharmacologic: Proton Pump Inhibitors (PPIs) are the most effective therapy for relieving symptoms and healing esophagitis. They are superior to H2-receptor blockers.
  • Lifestyle Modifications:
  • Weight Loss: Recommended for overweight/obese patients.
  • Head Elevation: Elevating the head of the bed is recommended for nocturnal symptoms.
  • Diet: Avoidance of trigger foods (alcohol, caffeine, spicy foods) should be individualized based on the patient's specific triggers.

    • 3. Monitoring

  • Refractory GERD: If symptoms persist despite standard PPI therapy, refer to a specialist for further evaluation (Endoscopy or pH monitoring).
    • 🚨

    Warning Signs

    ALARM FEATURES (Refer for Endoscopy)

  • Dysphagia: Difficulty swallowing.
  • Odynophagia: Painful swallowing.
  • Gastrointestinal Bleeding: Vomiting blood or black stools.
  • Unexplained Weight Loss.
  • Persistent Vomiting.
  • Iron Deficiency Anemia.

    • Reference

    1. Jose D. Sollano, M.D., et al. (Philippine Society of Gastroenterology / PJIM) (2014). Clinical Practice Guidelines on the Diagnosis and Treatment of Gastroesophageal Reflux Disease (GERD).
    Back to all protocols