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Walk the evidence base by book and chapter — the raw source passages that ground Ask, Differential, and the rest.
1 passage
An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease. IMPORTANCE: Gastroesophageal reflux disease (GERD) is prevalent worldwide, particularly in developed countries. It is estimated that the prevalence of GERD in the United States is approximately 20% and that it is increasing because of the epidemic of obesity. OBJECTIVE: To review the pathophysiology, clinical presentation, diagnostic evaluation, and treatment of GERD. EVIDENCE REVIEW: A search of PubMed was conducted for the years spanning 1985 to 2015 and included the following terms: heartburn, regurgitation, dysphagia, gastroesophageal reflux disease, cough, aspiration, laryngitis, GERD, GORD, endoscopy, manometry, pH monitoring, proton pump inhibitors, open fundoplication, and laparoscopic fundoplication. Only articles in English were included. FINDINGS: Lifestyle modifications, proton pump inhibitors, and laparoscopic fundoplication are proven treatment modalities for GERD. Endoscopic procedures have not been proven as effective. A Roux-en-Y gastric bypass is the procedure of choice when GERD and morbid obesity coexist. CONCLUSIONS AND RELEVANCE: Gastroesophageal reflux disease is a highly prevalent disease. Once the diagnosis has been established, the best results are obtained by a multidisciplinary team with the goal of individualizing treatment for patients.