This protocol applies to patients presenting with extraesophageal manifestations of GERD — such as chronic cough, hoarseness, or laryngitis — alongside typical GERD symptoms including heartburn and/or regurgitation.
The initial approach was a trial of twice-daily PPI therapy for 8 to 12 weeks. This protocol is indicated when that treatment did not achieve improvement of the extraesophageal symptoms.
When objective evidence of reflux is present, the next step may involve a surgical or endoscopic anti-reflux procedure. Full patient-selection criteria, sequencing, and the complete structured regimen are available via the link below.
DOI: 10.14309/ajg.0000000000001538
For patients who have both extraesophageal and typical GERD symptoms we suggest considering a trial of twice-daily PPI therapy for 8 to 12 weeks prior to additional testing.
In patients treated for extraesophageal reflux disease, surgical or endoscopic anti-reflux procedures are only recommended in patients with objective evidence of reflux.
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