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weight loss. Medication would include antacids and histamine 2 receptor antagonists (H2RAs). According to Woo & Wynne if the patient does not have esophageal erosive disease then they will be placed on H2RAs twice a day (2012).List differential diagnosis that would help confirm GERD while ruling out other diagnosis.Which medication is the best medication for treatment of GERD and why? What labs orother diagnostic tests that are used to confirm GERD?Differential diagnosis that would help confirm GERD while ruling out other diagnosis would be cholelithiasis, peptic ulcer disease, angina and gastritis just to name a few (Buttaro et al., 2017). Endoscopy is used to help confirm GERD. There are many more that could be a differential diagnosis. The best medications for treatment of GERD would be Antacids, H2 receptor blockers (H2RA’s) and Proton pump inhibitors (PPI’s). Henricks state “These medications are listed in increasing order of strength…, H2-receptor blockers are better at
reducing acid than antacids, and proton pump inhibitors are stronger than H2 receptor blockers” (2016). H2RAs helps to limit gastric parietal cells acid secretion, PPI’s suppresses the gastric acid juices more than 90 percent (Woo & Wynne, 2012). Depending on the symptoms of the patient, using the stepped approach, which consist of a step-up and step-down approach, may be beneficial for the patient (Woo & Wynne, 2012). The step-up approach has three steps. The first step would be lifestyle changes. This would include dietary changes such as avoiding fatty, greasy, acidic or spicy foods, limiting caffeine, smoking cessation and taking antacids. Making these changes will help to reduce the acid content in the stomach. When smoking, the LES tone is decreased and gastric acid secretions are increased (Woo & Wynne, 2012). According to Woo & Wynne, most patients have tried antacids. The second step in the step-up approach consist of continuing the life style changes and add H2RAs to the patient regime for 4 to 8 weeks. If the