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JAMA Diagnostic Test Interpretation
March 27, 2018

Gastroesophageal Reflux Monitoring

Author Affiliations
  • 1Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina
  • 2Durham Veterans Affairs Medical Center, Durham, North Carolina
  • 3Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri
JAMA. 2018;319(12):1271-1272. doi:10.1001/jama.2018.1144

A 56-year-old woman with no medical comorbidities presented to her primary care clinician with postprandial retrosternal burning that occurred multiple times daily for several years. She had no dysphagia, gastrointestinal bleeding, weight loss, anemia, or exertional chest pain. Over-the-counter antacids provided incomplete benefit. She was prescribed proton pump inhibitor (PPI) therapy with esomeprazole 40 mg, which she took daily, 30 minutes before breakfast. Her heartburn did not improve and continued to bother her daily despite adding famotidine at bedtime.