Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 19: Are The Therapeutic Choices Different For These Patients And, If So, How? (continued)

Treatment is based on extending the principles advocated for treating patients with heartburn and erosive esophagitis, observations from available clinical trials and clinical experience. The most efficient way to determine if symptoms/signs are due to laryngopharyngeal reflux (LPR) or pulmonary-related GERD is to attempt to eliminate the symptom(s) with a high-dose proton pump inhibitor (PPI) trial after other nonreflux causes of these symptoms have been excluded. This is because the weight of the available evidence supports the lack of sufficient sensitivity and specificity of endoscopy and…