EGD- esophagogastroduodenoscopy, F/U - follow-up; pH-24 hour pH study; R/O- rule out.

Figure 15

Algorithm for the approach to patients with gastroesophageal reflux disease. Patients who initially present with dysphagia in their symptom complex should undergo upper enodscopy immediately to evaluate the obstructive cause. Every patient who is considered for Nissen fundoplication should undergo 24-hour pH study and manometry to exclude esophageal motility disorder. Deabetic patients should also be studied by gastric emptying studies to evaluate the gastric motility.