GERD (as cause of Epigastric Pain)

Very hard to distinguish GERD from Peptic Ulcer Disease (PUD), Gastritis, & simple Dyspepsia.
  • Initial treatment is the same (H2-Receptor Blocker or Protom Pump Inhibitor, plus/minus Antacids)
Think PUD (or erosive Gastritis) when symptoms more severe for example:
  • Melena or Hematemesis
  • Upper abdominal pain most of the day, every day, for a week or more
  • Daily nausea, plus weight loss
  • History of prior episodes daily upper abdominal pain >3 weeks
  • History of prior GI Bleed (melena or hematemesis)
Think Dyspepsia if symptoms:
  • do NOT occur DAILY;
  • do NOT LAST the better part of the day
  •  NO bona fide epigastric tenderness (consistent, despite adequate distraction)
  • No suggestion of bleed as above
Think GERD:
  • prominent substernal pain or burning
  • sour taste in mouth, bloating
  • NO epigastric tenderness

Readers — Don’t be upset when you see the same blurb for PUD, Gastritis, Dyspepsia, & GERD.

See posting Abdominal Pain – 1.