By rray, 23 December, 2014 For typical GERD sx nonresponsive to PPI: endoscopy<sup>9</sup> to exclude non-GERD etiologies [C/L]
By rray, 23 December, 2014 If refractory GERD after these evals negative: ambulatory reflux<sup>8,11</sup> monitoring [S/L]
By rray, 23 December, 2014 Concomitant evaluation by ENT, pulmonary, and allergy specialists<sup>9</sup> [S/L]
By rray, 23 December, 2014 Not recommended: esophageal manometry [S/L], <i>H. pylori</i> screen [S/L], barium radiographs [S/H]
By rray, 23 December, 2014 If alarm sx (eg, dysphagia) or high risk of GERD complications: endoscopy<sup>9</sup> recommended
By rray, 23 December, 2014 If no typical GERD sx: reflux monitoring<sup>8</sup> prior to PPI trial [C/L]
By rray, 23 December, 2014 If typical GERD sx also present: consider PPI<sup>6</sup> trial<sup>7</sup> [S/L]
By rray, 23 December, 2014 Not recommended: ambulatory esophageal reflux monitoring,<sup>4</sup> barium radiographs<sup>5</sup> [S/H], esophageal manometry [S/L], <i>H. pylori</i> screen [S/L]
By rray, 23 December, 2014 If alarm sx (eg, dysphagia) or high risk of GERD complications: endoscopy<sup>3</sup> recommended