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This document updates an ACG guideline from 2013 (NEJM JW Gastroenterol May 2013 and Am J Gastroenterol 2013; 108:308). The guideline encompasses 30 pages and includes 39 recommendations covering all aspects of diagnosis and treatment. In this summary, I've chosen to highlight several points of particular relevance for primary care clinicians.
An empirical 8-week trial of a proton-pump inhibitor (PPI), given once daily, is recommended for a patient who has classic heartburn and regurgitation but no alarm symptoms. A good clinical response to PPIs is considered an adequate (although not perfect) diagnostic test for gastroesophageal reflux disease (GERD). Th…