INTRODUCTION
DR BURNS: Mrs J is a 59-year-old woman with a long history of gastroesophageal reflux disease (GERD) and documented Barrett esophagus. She lives near Boston with her husband and has 2 grown children. She sees her primary care physician, Dr W, and she has managed care insurance.
Mrs J initially developed symptoms of heartburn in the early 1990s and was prescribed ranitidine, 150 mg/d, which was later increased to twice daily without improvement. In 1993, Mrs J underwent an upper GI series, the results of which were normal; in 1994, test results for Helicobacter pylori were negative.
When Mrs J initially saw Dr W in 1996, she was taking ranitidine, 150 mg twice daily. At that time, her symptoms persisted throughout the day and night. She was drinking one glass of wine in the evening but did not find that it worsened her . . . [Full Text of this Article]
MRS J: HER VIEW
DR W: HIS VIEW
AT THE CROSSROADS: QUESTIONS FOR DR SPECHLER
Epidemiology of GERD
Helicobacter pylori and GERD
Initial Evaluation of Patients With GERD
Medical Treatment of GERD
Surgical Treatment of GERD
Barrett Esophagus
Management Recommendations for Patients With Barrett Esophagus
Recommendations for Mrs J
QUESTIONS AND DISCUSSION
