Gastroesophageal reflux
disease (GERD) is a chronic, relapsing condition with
associated morbidity and adverse impact on quality of life. GERD is a significant clinical
concern for primary care physicians because it affects an estimated 40% of the U.S.
population. The treating physician should be aware of new aspects of the underlying
science, clinical presentation, and treatment of GERD. GERD has a spectrum of clinical
presentations, from typical (eg, heartburn, regurgitation), to atypical (eg, chest pain,
dysphagia, cough, asthma, laryngitis), to complications (eg, ulcerations, hemorrhage,
stricture, Barrett’s esophagus, and adenocarcinoma).
Given the variability of the clinical presentation of GERD, the occurrence and impact
of nocturnal symptoms, and the high prevalence of this condition in the population,
primary care physicians need to elicit a thorough patient history in order to identify
both typical and atypical symptoms. Current management strategies require
familiarity with available diagnostic tests, lifestyle modifications, pharmacologic
therapy, maintenance therapy, complications of GERD, and when referral is necessary.
The American Medical Association is accredited by the Accreditation Council for
Continuing Medical Education (ACCME) to sponsor continuing medical education for
physicians. This enduring continuing medical education activity was planned and produced
in accordance with the ACCME Essentials.
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