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Tap the syringe gently to move bubbles to the top, then push the plunger slightly to expel them

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If patients have typical symptoms of GERD (heartburn or acid regurgitation or both) and no alarm symptoms, an 8-week trial of acid suppression therapy is appropriate If symptoms resolve completely with acid suppression but return when treatment is discontinued, the patient may have GERD but probably requires esophagogastroduodenoscopy for further evaluation of recurrent symptoms when PPI therapy has been held for 2 to 4 weeks If the patient has little or no response to acid suppression, further investigation is needed Atypical Symptoms of GERD GERD may cause or contribute to many different clinical syndromes