| SYMPTOM | HOW MANY TIMES DOES THIS OCCUR PER WEEK? | |||
|---|---|---|---|---|
| 0 DAYS | 1 DAY | 2 OR 3 DAYS | 4 TO 7 DAYS | |
|
Burning feeling behind the breastbone (heartburn) |
0 |
1 |
2 |
3 |
|
Stomach contents moving up to the throat or mouth (regurgitation) |
0 |
1 |
2 |
3 |
|
Pain in the middle of the upper stomach area |
3 |
2 |
1 |
0 |
|
Nausea |
3 |
2 |
1 |
0 |
|
Trouble getting a good night’s sleep because of heartburn or regurgitation |
0 |
1 |
2 |
3 |
|
Need for over-the-counter medicine for heartburn or regurgitation (such as Tums, Rolaids, Maalox, or other antacids), in addition to the medicine your doctor prescribed |
0 |
1 |
2 |
3 |
note: Add the point values for each corresponding answer.
Total score of 0 to 2 points = 0 percent likelihood of GERD; 3 to 7 points = 50 percent likelihood; 8 to 10 points = 79 percent likelihood; 11 to 18 points = 89 percent likelihood.
Reference
http://www.aafp.org/afp/2010/0515/p1278.html