Reference tool — not medical advice. Thresholds, targets, and first-line agents differ by guideline body and change over time — switch the lens to compare. Clinician judgement, dosing/monitoring, contraindications, and live coverage always required. Runs entirely in your browser — no data is collected.
GERD selector
Choose the guideline lens (ACG / AGA / Choosing Wisely Canada), the symptom frequency, type and treatment status — get the plan: alarm features → endoscopy first, lifestyle + PPI trial for typical GERD, optimize/investigate for non-responders, and PPI deprescribing when controlled long-term.
Guideline lens
Symptom frequencychoose one
Symptom typechoose one
Treatment statuschoose one
Flags
First step
Lifestyle + PRN antacid/H2RA
Notes
- • ACG uses an 8-week empiric PPI trial; supports one PPI switch (not more) for non-response; endoscopy for alarm features and to stage erosive/Barrett's disease.
Suggested drug classesPer ACG 2022.
Select symptom frequency and treatment status to begin.
Switch the lens to see the PPI-trial length (ACG 8wk vs AGA 4-8wk) and the deprescribing emphasis (strongest under Choosing Wisely Canada).
Guidelines
- 2022ACG — ACG Clinical Guideline: Diagnosis and Management of GERD (2022). 8-week empiric PPI; alarm→endoscopy; one PPI switch. link
- 2022AGA — AGA Clinical Practice Updates — personalized GERD + PPI de-prescribing (2022). 4–8-week trial; objective testing for atypical; deprescribing framework. link
- 2026Choosing Wisely Canada — Choosing Wisely Canada / CFP PPI deprescribing toolkit (2026). Strongest stewardship — annual attempt to stop/reduce; deprescribe as early as 4 weeks. link
References
- [1]Katz PO, et al. ACG Clinical Guideline: Diagnosis and Management of GERD. Am J Gastroenterol 2022;117:27 (8-week empiric PPI; alarm→endoscopy; one PPI switch; erosive/Barrett's staging). link
- [2]AGA Clinical Practice Updates: Personalized approach to GERD + De-Prescribing of PPIs. Gastroenterology 2022 (4–8-week trial; objective testing for atypical symptoms; deprescribing framework). link
- [3]Bland E, Veldhuyzen van Zanten S, Thompson W. Appropriate prescribing and deprescribing of PPIs: Choosing Wisely Canada toolkit. Can Fam Physician 2026;72:179. link