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<10%
10-20%
20-30%
>30%
Yes
No
May be
Raise the head of the bed
Eat a smaller potion of meal at bedtime
Don’t Lie down right after eating
All of the above
Symptoms
PH metry
Upper GI endoscopy
Impedance/PH metry
Any other
10% to 20%
20% to 30%
30% to 50%
>50%
Irritable Bowel Syndrome
Functional constipation
Dyspepsia
Nausea & Vomiting
Others
Bloating
Reflux / Regurgitation
Acidity / Heartburn
Early satiety
Nausea
Vomiting
Burping
Bed head elevation
Restraint in the consumption of foods such as : caffeine, alcoholic beverages and/or aerated drinks, mints, peppermints, tomato, chocolates
Particular precaution with high-risk medicines: anticholinergics, theophylline, calcium-channel blockers, alendronate
Restraint from reclining in the two hours after eating meals
Restraint from bigger meals
Quitting smoking
Body weight reduction
Antacid + PPI
Alginate Antacid + PPI
H2 Antagonist + PPI
Drug-drug interactions
Relative efficacy
Long-term use safety
Food-drug interaction
4-6 weeks
6-8weeks
8-10 weeks
10-12weeks
Proton Pump Inhibitor
Histamine 2 Receptors Antagonist
Prokinetics
Probiotics
Domperidone
Levosulpride
Itopride
Cinitapride
Symptom assessment
24- hour PH metry
Esophageal manometry
Double dose of PPI
PPI plus prokinetics
Addition of other antacid medication (for e.g. alginate based antacid)
Dual-release formulation
Patients who do not respond to a standard dose of PPI
Patients who do not respond to double doses of PPI
GERD patients with nausea and vomiting
1 week
2 weeks
2-4 weeks
> 4 weeks
>50