Primary Care Treatment Algorithm

Algorithm for heartburn/GERD in adults: primary care approach. *Cisapride 10 mg qid or 20 mg bid should be considered particularly if belching, bloating, or other postprandial symptom is present along with an absence of cardiac disease. Endoscopy should be considered if PPI use is required beyond 6 weeks. See algorithm on overview of specialist evaluation and treatment approach. H2RA = histamine H2 - receptor antagonist; LSM = lifestyle modifications; OTC = over the counter (nonprescription); PPI = proton pump inhibitor. Source: Practical Gastroenterology, April 1998.