Treatment Algorithm for Extraesophageal Manifestations of Gastroesophageal Reflux Disease (GERD) - Flowchart
Treatment Algorithm for Extraesophageal Manifestations of Gastroesophageal Reflux Disease (GERD) - Flowchart Gastroesophageal Reflux Disease (GERD) Gastroesophageal Reflux Disease (GERD)
«Flowchart»

Extraesophageal manifestations of GERD

Extraesophageal manifestations of GERD

Extraesophageal manifestations of GERD

Laryngitis

Laryngitis

Laryngitis

Asthma

Asthma

Asthma

Cough

Cough

Cough

Chest pain

Chest pain

Chest pain

Empiric trial of PPIs bid × 3-4 mo

Empiric trial of PPIs bid × 3-4 mo

Empiric trial of PPIs bid × 3-4 mo

End

End

End

Step-down therapy

Step-down therapy

Step-down therapy

Symptom assessment

Symptom assessment

Symptom assessment

No response

No response

No response

Response

Response

Response

Taper PPIs to qd; consider H2 blocker or prn PPIs

Taper PPIs to qd; consider H2 blocker or prn PPIs

Taper PPIs to qd; consider H2 blocker or prn PPIs

2


Reflux most likely not cause of symptoms
Look for another cause


Reflux most likely not cause of symptoms
Look for another cause


Reflux most likely not cause of symptoms
Look for another cause


Reflux most likely not cause of symptoms
Look for another cause


Intensify antireflux therapy
Consider laparoscopic fundoplication


Intensify antireflux therapy
Consider laparoscopic fundoplication


Intensify antireflux therapy
Consider laparoscopic fundoplication


Intensify antireflux therapy
Consider laparoscopic fundoplication

24-hr pH/impedance on medication

24-hr pH/impedance on medication

24-hr pH/impedance on medication

Normal

Normal

Normal

Abnormal

Abnormal

Abnormal