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Clinical Applications

Nicholas Shaheen, MD, MPH; David F. Ransohoff, MD

JAMA. 2002;287:1982-1986.

Gastroesophageal reflux disease (GERD), a condition commonly encountered in the primary care setting, is a risk factor for adenocarcinoma of the esophagus. Despite the ubiquity of the complaint, considerable uncertainty exists with respect to several basic questions, including when to perform endoscopy in patients with chronic reflux symptoms and how to address the cancer risk associated with GERD. These clinical vignettes illustrate common clinical questions encountered in caring for patients with GERD, especially as they relate to the issue of cancer risk. Applying data reviewed in the companion article, we propose practical answers to common clinical situations regarding care of patients with reflux. We also present an algorithm for treatment of patients with chronic GERD symptoms.

Author Affiliations: Division of Digestive Diseases and Nutrition, the Center for Esophageal Diseases and Swallowing, and the Center For Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill.

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