Clinical practice. Gastroesophageal reflux disease

N Engl J Med. 2008 Oct 16;359(16):1700-7. doi: 10.1056/NEJMcp0804684.


A 53-year-old man, who is otherwise healthy and has a 20-year history of occasional heartburn, reports having had worsening heartburn for the past 12 months, with daily symptoms that disturb his sleep. He reports having had no dysphagia, gastrointestinal bleeding, or weight loss and in fact has recently gained 20 lb (9 kg). What would you advise regarding his evaluation and treatment?

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Esophagus / pathology
  • Fundoplication*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / therapy*
  • Histamine Antagonists / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Proton Pump Inhibitors / therapeutic use*


  • Histamine Antagonists
  • Proton Pump Inhibitors