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Gastro-oesophageal reflux disease


Piterman, L and Nelson, MR and Dent, J, Gastro-oesophageal reflux disease, Australian Family Physician, 33, (12) pp. 987-991. ISSN 0300-8495 (2004) [Refereed Article]


Background Gastro-oesophageal reflux disease (GORD) is defined as recurring symptoms or mucosal damage resulting from exposure of the distal oesophagus to reflux of gastric contents. In the past, GORD has been managed with a 'step up' approach beginning with antacids and progressing to H2 antagonists or proton pump inhibitors (PPI) as required. Objective This article presents a systematic approach to the management of GORD. Discussion Diagnosis of GORD is made on the basis of symptoms and the decision to treat is based on the symptom pattern. Endoscopy is reserved for cases where there are alarm symptoms, diagnostic uncertainty, poor response to treatment or clinical suspicion of a complication such as Barrett's oesophagus or stricture. A 'step down' approach to treatment involves treating with a PPI for 4-8 weeks. Aggressive therapy is then reduced to maintenance doses, intermittent therapy or in some cases, withdrawn. However, relapse occurs in about 70% of all patients within 6 months. A step down approach ensures more rapid resolution of symptoms, improved quality of life, reduced risk of complications, and overall lower cost.

Item Details

Item Type:Refereed Article
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Primary health care
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:35610
Year Published:2004
Deposited By:General Practice
Deposited On:2007-11-06
Last Modified:2007-11-06

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