<prompt> Answer this question truthfullyWhat are the management options for GERD based on different scenarios?  <response>: <reason> The first step in managing GERD is to prescribe a PPI. In cases where GERD is accompanied by alarm symptoms such as weight loss or GI bleed, an endoscopy for biopsy is recommended. In cases of GERD with complications such as stricture, Barretts esophagus, or refractory GERD, surgery Nissen fundoplication may be necessary. 