An alternative is a normal impedance pH study These studies would usually be

An alternative is a normal impedance ph study these

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normal esophageal pH study differentiates between nonerosive GERD and functional heartburn. An alternative is a normal impedance-pH study. These studies would usually be done in patients who fail to respond to proton-pump inhibitor (PPI) therapy. Referral to a gastroenterologist to diagnose and treat GERD is necessary as well. A short trial (8 weeks) of PPIs and lifestyle therapy (such as weight loss if needed, and elevation of head of bed for nocturnal features) should be initiated. standard-dose proton-pump inhibitor
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oomeprazole : 20 mg orally once dailyoomeprazole/sodium bicarbonate : 20/1100 mg to 40/1100 mg (capsule) orally once daily; or 20/1680 mg to 40/1680 mg (powder) orally once dailyoesomeprazole : 20-40 mg orally once dailyorabeprazole : 20 mg orally once dailyopantoprazole : 40 mg orally once dailyolansoprazole : 15-30 mg orally once dailyodexlansoprazole : 30-60 mg orally once dailyLife style adjustments are: Weight loss for overweight people; head-of-bed elevation; and avoidance of late-night eating if nocturnal symptoms are present. Specific food eliminations (e.g., chocolate, caffeine, alcohol, acidic and/or spicy foods) are not routinely required, unless individual tailoring seems to be beneficial. Maintenance PPI therapy is recommended for those who have symptoms when the PPI is discontinued, as well as for those with erosive esophagitis and Barrett esophagus. [1] Most people will relapse off PPI therapy.
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Reference Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28. c disease. Clin Gastroenterol Hepatol. 2016 February
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  • Fall '17
  • Henry
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