GERD

Audience: Patients and providers
Status: Clinical guide · patient + provider
Last updated: 2026-03-09

1. Clinical overview

GERD is reflux of gastric contents that causes troublesome symptoms or complications, with management focused on symptom phenotype, alarm features, and appropriate use of acid suppression.

2. Common causes and risk factors

Reflux of gastric contents due to lower esophageal sphincter dysfunction and related factors.
Contributors: obesity, hiatal hernia, late meals, trigger foods, medications.

3. Typical symptoms

Heartburn, regurgitation, nocturnal symptoms, chronic cough/hoarseness in some cases.

4. Diagnosis and evaluation

Confirm diagnosis with guideline-based history, exam, and indicated testing.
Screen for severity, complications, and high-risk comorbid conditions.
Identify social or access barriers that could affect treatment success.

5. Treatment (non-pharmacologic)

Weight reduction if indicated, meal timing, head-of-bed elevation, trigger reduction.
Avoid tobacco and excess alcohol.

6. Treatment (pharmacologic)

PPIs such as omeprazole, pantoprazole, esomeprazole, or lansoprazole are standard first-line agents for typical persistent symptoms.
H2 blockers such as famotidine can be useful for milder or intermittent symptoms and for selected nighttime breakthrough symptoms.
Sucralfate is mainly relevant in limited scenarios, and persistent alarm symptoms should trigger evaluation rather than repeated acid-suppression escalation.

7. Monitoring and follow-up

Symptom response, recurrence, alarm features, and long-term therapy necessity.

8. Practical counseling points

Give patients a clear “what to do today / when to call / when to seek urgent care” plan.
Use teach-back to confirm understanding of treatment goals and medication instructions.
Simplify regimens when possible to improve adherence and outcomes.

9. Red flags and escalation

Escalate care urgently for severe or rapidly worsening symptoms.
Reassess diagnosis if expected response does not occur within the anticipated timeline.

10. Guideline references

Note: Educational guide only; not a substitute for individualized medical care.