Gastroenterology and hepatology
Gastro-oesophageal reflux disease
Typical and atypical reflux, the PPI trial, who needs gastroscopy, Lyon 2.0 criteria for proving reflux, PPI-refractory symptoms, surgery, and the complications to look for.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Heartburn and regurgitation are the typical symptoms. Either, at least twice a week, makes GORD likely.
- Most patients with typical symptoms and no alarm features get an empirical 8-week PPI trial without investigation.
- Most symptomatic patients have non-erosive reflux disease (NERD), with a normal gastroscopy. Normal endoscopy doesn't exclude GORD.
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Sources
- Therapeutic Guidelines: Gastrointestinal (eTG complete), gastro-oesophageal reflux diseaseAU/NZTherapeutic Guidelines Limited
- Katz PO et al. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol 2022;117:27-56American College of Gastroenterology, 2022
- Gyawali CP et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut 2024;73:361-71Lyon Consensus Group (Gut), 2024
- Shaheen NJ et al. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus. Am J Gastroenterol 2022;117:559-87American College of Gastroenterology, 2022
- Desai M et al. American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations. Gastrointest Endosc 2025;101:267-84American Society for Gastrointestinal Endoscopy, 2025
- Choosing Wisely Australia: Gastroenterological Society of Australia recommendations (long-term PPI review)AU/NZChoosing Wisely Australia and Gastroenterological Society of Australia
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy