The Singapore Family Physician

Back to issue Vol 35 No. 1 - Gastrointestinal diseases

Diagnosis and Management of Gastroesophageal reflux disease

Fock Kwong Ming
The Singapore Family Physician Vol 35 No 1 - Gastrointestinal diseases
10 - 12
1 March 2009
0377-5305
GERD is defined as a disorder in which gastric contents reflux recurrently into the esophagus, causing troublesome symptoms and/or complications. GERD is becoming more prevalent in Singapore and the diagnosis for most cases is straightforward. Heartburn and regurgitation (or both) that occurs after meals are symptoms highly specific for GERD. For patients with alarm symptoms or recurrent GERD, referral to gastroenterologists is advised. The gold standard for diagnosis of erosive GERD is an upper GI endoscopy. Presently, there is no gold standard for the diagnosis of non-erosive GERD. The role of endoscopy is to define the presence of esophageal mucosal involvement (including erosions, ulceration, stricture, Barrett’s metaplasia and esophageal cancer) and to exclude other upper GI pathology. Endoscopy provides a diagnosis (biopsy) and/or therapy (dilation, etc.) for the complications of GERD. First line management of GERD is pharmacological with some lifestyle modifications. Surgical treatment in experienced hands can be considered in selected patients.