Gastroesophageal reflux disease: diagnosis and medical therapy.

Gastroesophageal reflux disease (GERD) is a common clinical condition that affects all age groups, particularly older adults. Its presentation is diverse and can range from occasional heartburn to disabling complications. A complete history can usually lead to the diagnosis, although further testing may be needed for refractory symptoms, complications, and atypical presentations. Multiple therapeutic options are available, and decisions governing their use are based on symptoms and severity of esophagitis. All patients should be instructed to make dietary and other lifestyle adjustments. Antacids may be needed for mild symptoms. Pharmacologic options for moderately severe cases include H2 blockers, a proton pump inhibitor, or others. Surgery is reserved for cases of severe refractory disease.