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Misdiagnosis of Gastroesophageal Reflux Disease

Misdiagnosis of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is not difficult to diagnose, however, it may be difficult to pinpoint the exact cause of GERD....more about Gastroesophageal Reflux Disease »

Alternative diagnoses list for Gastroesophageal Reflux Disease:

For a diagnosis of Gastroesophageal Reflux Disease, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Gastroesophageal Reflux Disease:

Diseases for which Gastroesophageal Reflux Disease may be an alternative diagnosis

The other diseases for which Gastroesophageal Reflux Disease is listed as a possible alternative diagnosis in their lists include:

Gastroesophageal Reflux Disease: Hidden Causes Misdiagnosed?

Causes of Gastroesophageal Reflux Disease may include these medical conditions:

  • Hiatal hernia
  • Esophagus inflammation
  • Gastroesophageal reflux is a common condition that often occurs without symptoms after meals. In some people, the reflux is related to a problem with the lower esophageal sphincter, a band of muscle fibers that usually closes off the esophagus from the stomach. If this sphincter doesn't close properly, food and liquid can move backward into the esophagus and may cause the symptoms
  • more causes...»

Rare Types of Gastroesophageal Reflux Disease:

Gastroesophageal Reflux Disease: Medical Mistakes

Related medical mistakes may include:

Gastroesophageal Reflux Disease: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Common Misdiagnoses and Gastroesophageal Reflux Disease

Heart attacks can be undiagnosed: Although the most severe symptoms of heart attack are hard to miss, there are varying degrees of severity. It is altogether too common for people to die from undiagnosed heart attack, or from delaying too long to call for emergency help. The prognosis for treatment is far better for patients treated in the early stages of a heart attack. The most common misdiagnoses include heartburn, or other less severe causes of chest pain. See the introduction to heart attack and the symptoms of heart attack.

Heart attacks can be overdiagnosed: Although many people die from heart attacks, there are also many cases where people fear that they have a heart attack, but actually have something milder. Some of the conditions which may be causes of chest pain, causing fear of a heart attack, including an anxiety attack, heartburn, and so on. See the causes of chest pain and the symptoms of heart attack.

Chronic digestive conditions often misdiagnosed: When diagnosing chronic symptoms of the digestive tract, there are a variety of conditions that may be misdiagnosed. The best known, irritable bowel syndrome, is over-diagnosed, whereas other causes that are less known may be overlooked or misdiagnosed: celiac disease, Crohn's disease, ulcerative colitis (both are called inflammatory bowel disease (IBD)), diabetic gastroparesis, diabetic diarrhea. Other possibilities include giardia, colon cancer, or other chronic infections.

Intestinal bacteria disorder may be hidden cause: One of the lesser known causes of diarrhea is an imbalance of bacterial in the gut, sometimes called intestinal imbalance. The digestive system contains a variety of "good" bacteria that aid digestion, and they can decline for various reasons, leading to digestive symptoms such as diarrhea. The main treatment is to eat foods containing probiotics, typically yoghurt cultures. See intestinal imbalance and probiotics.

Antibiotics often causes diarrhea: The use of antibiotics are very likely to cause some level of diarrhea in patients. The reason is that antibiotics kill off not only "bad" bacteria, but can also kill the "good" bacteria in the gut. This leads to "digestive imbalance" where there are too few remaining "good" bacteria in the digestive system. The treatment is typically to use "probiotics", such as by eating yoghurt cultures containing more of the good bacteria. See digestive imbalance and probiotics.

Heart attack can be over-diagnosed: Although heart attack is often undiagnosed, leading to fatality, it can also be over-diagnosed. People become concerned that a condition is a heart attack, whereas there are various less dangerous possibilities. After all, there are numerous causes of chest pain. Some of the common conditions where a person may become concerned about a possible heart attack include a panic attack (which often has both chest pain and difficulty breathing), and heartburn/reflux type conditions. Nevertheless, chest pain itself can be a potentially life-threatening symptoms, and needs immediate professional attention.

Food poisoning may actually be an infectious disease: Many people who come down with "stomach symptoms" like diarrhea assume that it's "something I ate" (i.e. food poisoning). In fact, it's more likely to be an infectious diarrheal illness (i.e. infectious diarrhea), that has been caught from another person. Such conditions may be transmitted via the fecal-oral route.

Mesenteric adenitis misdiagnosed as appendicitis in children: Because appendicitis is one of the more feared conditions for a child with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for children with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

Celiac disease often fails to be diagnosed cause of chronic digestive symptoms: One of the most common chronic digestive conditions is celiac disease, a malabsorption disorder with a variety of symptoms (see symptoms of celiac disease). A variety of other chronic digestive disorders tend to be diagnosed rather than this condition. See introduction to celiac disease or misdiagnosis of celiac disease.

Chronic digestive diseases hard to diagnose: There is an inherent difficulty in diagnosing the various types of chronic digestive diseases. Some of the better known possibilities are peptic ulcer, colon cancer, irritable bowel syndrome, or GERD. Other sometimes overlooked possibilities include Crohn's disease, ulcerative colitis, chronic appendicitis, Celiac disease, Carcinoid syndrome, gastroparesis, and others. See all types of chronic digestive diseases.

Chronic lung diseases hard to diagnose: Some of the chronic lung diseases are difficult to diagnose. Even the well-knowns conditions such as asthma or lung cancer often fail to be diagnosed early. Some of the chronic lung diseases with diagnostic difficulties include asthma (perhaps surprisingly), COPD, emphysema, chronic bronchitis, cystic fibrosis, mesothelioma, smoker's cough, AIDS-related respiratory conditions (see AIDS), chronic pneumonia, and other respiratory diseases. Rare possibilities include diseases like psittacosis (bird-related lung infection). See other types of chronic lung diseases.

Gastroesophageal Reflux Disease: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Gastroesophageal Reflux Disease

Failure to diagnose Gastroesophageal Reflux Disease may be associated with the following:

  • Undiagnosed GERD can lead to complications such as esophagitis, iron-deficiency anemia, strictures, respiratory problems (asthma, pneumonia), swallowing problems and Barrett's esophagus which is a premalignant condition
  • Other complications of undiagnosed GERD are chronic cough, chest pain, hoarseness, eroded teeth, laryngeal cancer, pharyngitis, chronic sinusitis and vocal cord polyps
  • Some cases of GERD cause no heartburn which prevents diagnosis and in fact means that sufferers are unaware that there is even anything wrong
  • The lack of clinical signs in many cases means that a lot of cases of GERD are not diagnosed
  • One of the complications of undiagnosed GERD is scarring of the esophagus which can actually reduce heartburn symptoms and mistakenly lead patients to believe they are getting better
  • Chronic untreated GERD can also lead to Barrett's esophagus which is a precancerous condition. Often heartburn symptoms lessen during this phase which may deceive patients into believing they are getting better
  • Failure to diagnose GERD often leads to Barrett's esophagus and ultimately esophageal cancer which has poor survival rates
  • Undiagnosed and untreated GERD can exacerbate asthma symptoms
  • Test results can be misleading in some cases as up to a half of GERD patients have a normal gastroscopy result. The barium swallow and meal is not very sensitive in detecting inflammation of the esophageal lining and often indicates GERD in normal asymptomatic people
  • GERD is often undiagnosed in infants as symptoms are difficult to determine
  • The presentation of atypical symptoms (vocal cord polyps, adult-onset asthma, chronic cough, hoarse voice) may hinder diagnosis
  • GERD is often undiagnosed due to the fact that the presenting symptoms are quite variable and may often be attributed to other causes
  • Failure to diagnose GERD in infants can result in a range of complications including failure to thrive, apnea, aspiration pneumonia and asthma

Notes On Hidden Causes Of Gastroesophageal Reflux Disease

The following may be hidden causes of Gastroesophageal Reflux Disease:

  • Causes of GERD include obesity, hiatus hernia and certain drugs (NSAIDs, antidepressants, anticholinergics and calcium-channel blockers)
  • Factors that can exacerbate GERD are fatty food, spicy food, eating late at night, alcohol, hot drinks, smoking, pregnancy, tight clothing around the abdomen, vigorous exercise, bending over or lying down frequently and large meals
  • Other conditions that may cause GERD are Zollinger-Ellison syndrome, partial gastrectomy, Heller's cardiomyopathy and systemic sclerosis
  • Other causes of GERD include: pyloric surgery, long-term nasogastric intubation
  • Particular foods that can lead to an episode of reflux includes: chocolate, garlic, onions, mint flavouring, tomato-based foods, citrus fruit and caffeine-containing drinks

Notes On Wrong Diagnosis Of Gastroesophageal Reflux Disease

Wrong diagnosis of Gastroesophageal Reflux Disease may be associated with the following:

  • Chest pain caused by a heart condition is sometimes misdiagnosed as GERD
  • Studies indicate that many infants diagnosed with cow's milk allergy actually have GERD
  • GERD is often misdiagnosed when the only presenting symptoms are throat and vocal cord symptoms
  • GERD is often misdiagnosed as dyspepsia
  • If treatment for GERD fails to make any difference to symptoms then the patient may have been misdiagnosed and further investigation is warranted

Complications Of Misdiagnosis Of Gastroesophageal Reflux Disease

The following may be complications of misdiagnosis of Gastroesophageal Reflux Disease:

  • Manifestations of GERD are often misdiagnosed as other conditions unrelated to the actual cause e.g. chronic cough, hoarseness
  • Asthma-like symptoms caused by GERD may be misdiagnosed as asthma
  • Chest pain due to GERD may be misdiagnosed as angina or heart pain. To make diagnosis even more confusion, antianginal therapy such as glyceryl trinitrate spray can actually alleviate esophageal spasms associated with GERD. Also, chest pain caused by GERD may worsen with exercise which can also provide misleading support for a heart complaint rather than GERD
  • Vomiting in infants due to GERD can be misdiagnosed as necrotizing enterocolitis, pyloric stenosis, intestinal atresia, Hirschsprung's disease, malrotated gut, peptic ulcer disease, inborn error of metabolism or meconium ileus
  • Pneumonia due to aspiration associated with GERD may be misdiagnosed simply as pneumonia
  • Hoarseness and sore throat caused by GERD may be misdiagnosed as infectious pharyngitis
  • Tooth erosion in GERD patients who have no other symptoms is often misdiagnosed as poor dental hygiene, defective tooth enamel, diet problems or an eating disorder

Other Notes On Misdiagnosis Of Gastroesophageal Reflux Disease

  • Regular bouts of heartburn should not be ignored as the consequences can be serious. In general, people who have two or more bouts of heartburn a week should be assessed for GERD
  • Children with asthma are more likely to have GERD than the general population
  • Nausea is sometimes associated with GERD but may be put down as due to other causes
  • Some studies indicate that untreated GERD may in fact cause asthma in some cases
  • Some medical experts believe that GERD is being overdiagnosed in infants and young children. As the public has become more informed about the existence of the condition, parents with infants who spit up frequently tend to insist on treatment for the condition without conclusive diagnosis. Other experts claim that infants are being underdiagnosed because mothers are not well-informed about GERD

Medical news summaries about misdiagnosis of Gastroesophageal Reflux Disease:

The following medical news items are relevant to misdiagnosis of Gastroesophageal Reflux Disease:

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Gastroesophageal Reflux Disease or confirming a diagnosis of Gastroesophageal Reflux Disease, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Gastroesophageal Reflux Disease may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Gastroesophageal Reflux Disease. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.


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