https://idwiki.org/index.php?action=history&feed=atom&title=Gastroesophageal_reflux 2026-04-29T00:23:38Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Gastroesophageal_reflux&diff=4225&oldid=prev 2020-07-04T01:17:35Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Definition ==<br /> <br /> * Chronic non-forceful reflux of stomach contents past lower esophageal sphincter, producing a variety of symptoms<br /> <br /> == Classification ==<br /> <br /> * May be erosive or non-erosive (NERD)<br /> <br /> == Pathophysiology ==<br /> <br /> * Decreased tone of lower esophageal sphincter that normally prevents regurgitation<br /> <br /> == Differential Diagnosis ==<br /> <br /> * Heartburn symptoms<br /> ** Myocardial ischemia<br /> * Chronic cough<br /> ** Asthma<br /> ** Upper airway syndrome (post-nasal drip)<br /> <br /> == Management ==<br /> <br /> * Stepwise management<br /> * Step 1: lifestyle management<br /> ** No food for 4h before sleeping<br /> ** Eat upright, stay upright for 1h after meal<br /> ** Avoidance of trigger foods, such as coffee, alcohol, spicy food<br /> ** Sleep with elevated head of bed<br /> * Step 2: proton pump inhibitor (PPI) therapy<br /> ** Pantoprazole 40mg po daily 30 minutes before breakfast<br /> * Step 3: twice-daily PPI<br /> ** As above, but bid 30 minutes before breakfast and dinner<br /> * Step 4: things for which there is no evidence<br /> ** Consider further investigations such as 24h pH monitoring<br /> <br /> [[Category:Gastroenterology]]</div>

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