Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Due to the wide range of presentation in GERD patients with esophageal and/or extraesophageal syndromes that are common symptoms but often overlapping those of other upper gastrointestinal and cardiopulmonary disorders, a systematic approach to the preoperative workup of these patients must be undertaken to identify objective evidence of esophageal reflux prior to surgery. The workup should include upper endoscopy, barium esophagram, manometry and pH study with very few exceptions. Only after successful objective identification of pathologic acid exposure should surgery be pursued for select patients.
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