Gastroesophageal reflux disease (GERD), also known as acid reflux occurs when acid or other stomach contents back up in the esophagus. The most common symptom of GERD is heartburn, which, while rarely life-threatening, can greatly reduce a patient's quality of life by affecting daily activities, sleep and what they can eat.
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Estimates are that more than 60 million Americans experience heartburn at least once a month and 15 million suffer from it daily. PPIs have been widely used for many years and are now available over the counter directly to consumers as an effective way to treat reflux symptoms.
However, newer data highlights some safety concerns with long-term use that is important to discuss with patients. Health-care providers should be aware of the potential adverse relationship between PPI use and community-acquired pneumonia, namely, a small relative risk associated with short-term and high-dose PPI use.
For pharmacological treatment of patients with GERD, long-term acid suppression therapy (PPIs or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals.
Question: A 44-year-old man presented for evaluation of GERD and episodic chest tightness lasting several months. Physical examination revealed a fit, well-appearing man without any abnormal findings. Despite resolution of pyrosis and regurgitation with a trial of omeprazole, he still had a sensation of chest tightness that occurred intermittently with eating and drinking. At that time, he denied dysphagia or odynophagia. He also denied abdominal pain, weight loss, fever, chills, nausea, vomiting and changes in bowel movements.
AGA provides several patient guides, books and other resources to help your patients understand their GERD diagnosis and the steps you will take along with them to manage their disease.
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