Gastroesophageal Reflux Disease Differential Diagnoses

Updated: Nov 27, 2023
  • Author: Marco G Patti, MD; Chief Editor: BS Anand, MD  more...
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Diagnostic Considerations

Gastroesophageal reflux may be classified into three categories, as follows:

  • Physiologic (or functional) gastroesophageal reflux: These patients have no underlying predisposing factors or conditions; growth and development are normal; and pharmacologic treatment is typically not necessary, though it may be needed to relieve symptoms if lifestyle changes are unsuccessful. [7]

  • Pathologic gastroesophageal reflux or GERD: Patients frequently experience complications noted above, requiring careful evaluation and treatment [26]

  • Secondary gastroesophageal reflux: This refers to a case in which an underlying condition may predispose to gastroesophageal reflux, with examples including asthma (a condition that may also be, in part, caused by or exacerbated by reflux) and gastric outlet obstruction

The diagnosis of GERD in patients with atypical symptoms can be difficult. When patients present with atypical complaints, the diagnosis of GERD must be kept in mind. Patients with recurrent aspiration can have asthma, history of pneumonias, and progressive pulmonary fibrosis. Additionally, hoarseness can be present due to chronic laryngeal irritation. Chest pain is another presenting symptom that can be difficult to evaluate. In these patients, excluding cardiac etiology is important prior to labeling the pain as noncardiac chest pain secondary to GERD.

The clinical presentation of GERD in pregnant women is similar to that for the general population. Heartburn and regurgitation are the cardinal symptoms. The diagnostic evaluation consists of a thorough history and physical examination.

Differential Diagnoses