Assignment: Differential Diagnosis for GERD
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Differential Diagnosis for GERD
Gastroesophageal reflux disease or GERD is characterized by heartburn or burning pain that radiates up the esophagus usually within an hour after eating. Other diseases that also have these symptoms and need to be considered to help confirm the diagnosis of GERD include cholelithiasis, peptic ulcer disease, gastritis, and angina (Freshman, 2017). The confirmed diagnosis comes after a trial period of medication to treat GERD (Woo, 2017).
Treatment for GERD
The initial treatment for GERD is lifestyle modifications. When patients come to see a provider to seek treatment for their heartburn pain, they usually have already taken OTC antacids or H2Ras without improvement of symptoms (Woo, 2017). The best pharmaceutical treatment for GERD is a prescription dose of proton pump inhibitors (PPIs). PPI reduce acid production and improve the symptoms of GERD (Freshman, 2017). All PPIs are approved to treat GERD and initial dosing is determined by the patient’s history of present illness to treat for symptomatic GERD or chronic GERD due to an erosion of the esophagus. The type of PPI prescribe is determined by other medications that the patient is taking or if they are unable to swallow pills whole then they will be prescribed omeprazole, esomeprazole, and lansoprazole where the capsules can be opened, and the granules can be added to a small amount of apple sauce to swallow easier. The main treatment for GERD is for the patient to take a PPI once a day for eight weeks. The medication should be taken first thing in the morning 30 to 60 minutes before breakfast (Woo, 2017).
Labs and Tests to Confirm GERD
The physical exam and history of illness described by the patient is the best evaluation to determine diagnosis followed by a trail of PPI for eight weeks to determine if the symptoms are controlled. If the symptoms are not controlled, then more testing will begin to check for other causes of the heartburn pain.
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