Typical symptoms in patients with GERD are extremely important in making the diagnosis. It is important to note that heartburn, and more commonly dysphagia (difficulty swallowing), may be due to causes other than reflux disease. It should also be noted that extra-esophageal manifestations of reflux (symptoms attributable to organ systems other than the esophagus) may be due to primary disease in the upper or lower respiratory tract.
Symptoms of reflux disease can, however, be shown to be a consequence of reflux (stomach contents flowing backward into the esophagus) if they respond to a trial of reflux therapy. Thus, the first test that should be performed for such patients is a trial of therapy. Trials also can be considered in patients at low risk for serious complications from reflux disease (younger patients with shorter duration of symptoms who do not have any alarming symptoms such as weight loss, difficulty swallowing, low blood count, or gastrointestinal bleeding). Read the rest of this entry »