II. Scoring

  1. How many times per week do each of the following symptoms occur per week
  2. Answers
    1. Score 0: Occurs on 0 days
    2. Score 1: Occurs on 1 day
    3. Score 2: Occurs on 2-3 days
    4. Score 3: Occurs on 4-7 days

III. Questions (Score 0-3 for each based on above)

  1. Burning feeling behind the Breastbone (Heartburn)?
  2. Stomach contents moving up to the throat or mouth (regurgitation)?
  3. Pain in the middle of the upper Stomach area?
  4. Nausea?
  5. Trouble getting a good night's sleep because of Heartburn or regurgitation?
  6. Need for over-the-counter medicine for Heartburn or regurgitation?
    1. Examples: Tums, Rolaids, Maalox, or other Antacids)
    2. In addition to the medicine your doctor prescribed

IV. Interpretation

  1. Total score of 0-2 points
    1. Likelihood of GERD: 0%
  2. Total score of 3-7 points
    1. Likelihood of GERD: 50%
  3. Total score of 8-10 points
    1. Likelihood of GERD: 79%
  4. Total score of 11-18 points
    1. Likelihood of GERD: 89%

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