Focus on gastroesophageal reflux disease in patients with cystic fibrosis

Table 2 Diagnostic and therapeutic management of gastroesophageal reflux disease in adult patients with cystic fibrosis

Adult patients
Typical symptoms	Heartburn, regurgitation
Diagnostic tests indications
PPIs Trial	Classical symptoms
Barium Swallow	Not for GERD diagnosis
Endoscopy	In presence of alarm symptoms
Esophageal biopsy	Exclude non-GERD diagnosis
Esophageal manometry
Therapy	PPI for eight weeks
Additional options	Lifestyle modifications
	Alginate or antiacide for symptoms relief
Complications associated to therapy	Clostridium difficile infection
	Risk of community-acquired pneumonia
	with a short-term PPI

PPIs: Proton pump inhibitors; GERD: Gastroesophageal reflux disease.