The ACP finds that medication to reduce gastric acid production is warranted in most patients with typical symptoms of GERD or gastroesophageal reflux disease. They find for patients who are unresponsive to medicine upper endoscopy is appropriate. They also recommend endoscopy when serious symptoms are present, such as difficult or painful swallowing, bleeding, anemia, weight loss, or recurrent vomiting.
Symptoms of GERD including heartburn are one of the most common reasons people see a doctor. Each year more than 113 million prescriptions are filled to treat GERD, costing $14 billion dollars-making it the third largest selling drug category in the world.
For men over the age of 50 with multiple risk factors, screening with upper endoscopy may be needed for Barrett's esophagus, a disorder in which the lining of the esophagus is damaged by stomach acid and may lead to cancer.