GERD (acid reflux)
What the FAA's documents say about GERD (acid reflux), in plain words, with the FAA's own words one press away.
FAA term: GERD (gastroesophageal reflux disease or reflux)Covers: All classes
Show the FAA's words: which classes the FAA's table covers
GERD (gastroesophageal reflux disease or reflux) All Classes
Short version
The GERD disposition table has three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ALifestyle or diet changes, or acceptable medication | Examiner issues | Examiner can issue |
| Row BA surgical procedure 2 or more months ago | Examiner issues | Examiner can issue |
| Row CSevere, surgery less than 2 months ago, or recurrent procedures | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for GERD (acid reflux)
- Row A · Examiner can issue
GERD treated with lifestyle or diet changes, or with acceptable medication. If the examiner can determine the condition is under control, medications are acceptable, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner summarizes in Item 60, including if medications are needed or any complications.
A. Treated with lifestyle/diet changes or acceptable medication … If the AME can determine the condition is under control, medications are acceptable, and the individual has no symptoms that would interfere with flight or safety related duties: ISSUE Summarize in Item 60 including if meds are needed or any complications.
- Row B · Examiner can issue
GERD requiring a surgical procedure 2 or more months ago. If the examiner can determine through history and exam that the surgery was 2 or more months ago with no complications, no evidence of GI bleed or cancer, and the condition has resolved, the table says ISSUE. The examiner summarizes the findings in Item 60 and must specifically mention whether there were any complications.
B. Requiring a surgical procedure 2 or more months ago … If the AME can determine through history and exam, the surgery was 2 or more months ago with no complications, no evidence of GI bleed or cancer, and the condition has resolved: ISSUE Summarize findings in Item 60. AME must specifically mention if any complications.
- Row C · Special Issuance
Severe GERD, or GERD requiring a surgical procedure less than 2 months ago, or recurrent procedures. The row's note says most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication. The table lists what to submit to the FAA. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
C. Severe or Requiring surgical procedure less than 2 months ago or Recurrent procedure(s) … NOTE: most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication. … Submit the following to the FAA: … DEFER Submit the information to the FAA for a possible Special Issuance Summarize findings in Item 60.
The FAA pathways for GERD (acid reflux)
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: What the examiner determines for row A
Control, medications, and symptoms.Your AME determines the three things row A lists.
Your AME determines
- The condition is under control
- Medications are acceptable
- No symptoms that would interfere with flight or safety related duties
Your AME's summary in Item 60
- Including if medications are needed or any complications
Show the FAA's words: What the examiner determines for row A
If the AME can determine the condition is under control, medications are acceptable, and the individual has no symptoms that would interfere with flight or safety related duties:
FAA source: GERD Disposition Table. FAA date 25 March 2026; checked by Crosscheck 14 October 2026.
ISSUE Summarize in Item 60 including if meds are needed or any complications.
FAA source: GERD Disposition Table. FAA date 25 March 2026; checked by Crosscheck 14 October 2026.
Step 2: See your AME
If the examiner can determine the condition is under control, medications are acceptable, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner summarizes in Item 60, including if medications are needed or any complications.Exam day- If the examiner can determine the condition is under control, medications are acceptable, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner summarizes in Item 60, including if medications are needed or any complications.
Show the FAA's words: See your AME
A. Treated with lifestyle/diet changes or acceptable medication
If the AME can determine the condition is under control, medications are acceptable, and the individual has no symptoms that would interfere with flight or safety related duties: ISSUE Summarize in Item 60 including if meds are needed or any complications.
FAA source: GERD Disposition Table. FAA date 25 March 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
If the examiner can determine the condition is under control, medications are acceptable, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner summarizes in Item 60, including if medications are needed or any complications.
Row BExaminer issuesExaminer can issue
If the examiner can determine through history and exam that the surgery was 2 or more months ago with no complications, no evidence of GI bleed or cancer, and the condition has resolved, the table says ISSUE. The examiner summarizes the findings in Item 60 and must specifically mention whether there were any complications.
Row CDefers to the FAASpecial Issuance
The table lists what to submit to the FAA. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
GERD treated with lifestyle or diet changes, or with acceptable medication. If the examiner can determine the condition is under control, medications are acceptable, and there are no symptoms that would interfere with flight or safety related duties, the table says ISSUE. The examiner summarizes in Item 60, including if medications are needed or any complications.
A. Treated with lifestyle/diet changes or acceptable medication … If the AME can determine the condition is under control, medications are acceptable, and the individual has no symptoms that would interfere with flight or safety related duties: ISSUE Summarize in Item 60 including if meds are needed or any complications.
- Row B · Examiner can issue
GERD requiring a surgical procedure 2 or more months ago. If the examiner can determine through history and exam that the surgery was 2 or more months ago with no complications, no evidence of GI bleed or cancer, and the condition has resolved, the table says ISSUE. The examiner summarizes the findings in Item 60 and must specifically mention whether there were any complications.
B. Requiring a surgical procedure 2 or more months ago … If the AME can determine through history and exam, the surgery was 2 or more months ago with no complications, no evidence of GI bleed or cancer, and the condition has resolved: ISSUE Summarize findings in Item 60. AME must specifically mention if any complications.
- Row C · Special Issuance
Severe GERD, or GERD requiring a surgical procedure less than 2 months ago, or recurrent procedures. The row's note says most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication. The table lists what to submit to the FAA. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60.
C. Severe or Requiring surgical procedure less than 2 months ago or Recurrent procedure(s) … NOTE: most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication. … Submit the following to the FAA: … DEFER Submit the information to the FAA for a possible Special Issuance Summarize findings in Item 60.
If the examiner defersSpecial Issuance
The table marks row C, severe GERD, a surgical procedure less than 2 months ago, or recurrent procedures, DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note generated from a clinic visit with the treating gastroenterologist or surgeon no more than 90 days before the exam, including what the table lists.
- Item 2. Items the physician specifically addresses: etiology, surgical outcomes, and any complications. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
- Item 3. Other testing performed or deemed clinically necessary by the treating physician.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks row C, severe GERD, a surgical procedure less than 2 months ago, or recurrent procedures, DEFER.
C. Severe or Requiring surgical procedure less than 2 months ago or Recurrent procedure(s) … DEFER Submit the information to the FAA for a possible Special Issuance
What the FAA lists to send
- Item 1
A current, detailed clinical progress note generated from a clinic visit with the treating gastroenterologist or surgeon no more than 90 days before the exam, including what the table lists.
1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating gastroenterologist or surgeon no more than 90 days before the AME exam. It must include
- Item 2
Items the physician specifically addresses: etiology, surgical outcomes, and any complications. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
2. It must specifically include etiology, surgical outcomes, and any complications.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
- Item 3
Other testing performed or deemed clinically necessary by the treating physician.
3. Other testing performed or deemed clinically necessary by the treating physician.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Two months after surgery is the line
The table puts a surgical procedure 2 or more months ago in row B, marked ISSUE, and a surgical procedure less than 2 months ago in row C, marked DEFER.
Show the FAA's words: good to know, 2
B. Requiring a surgical procedure 2 or more months ago … ISSUE … C. Severe or Requiring surgical procedure less than 2 months ago … DEFER Submit the information to the FAA for a possible Special Issuance
The table's note on recovery after surgery
Row C's note says most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication.
Show the FAA's words: good to know, 3
NOTE: most require a six (6) week recovery period after a surgical procedure such as Nissen fundoplication.
Recurrent procedures are in row C
Recurrent procedures are in row C with severe GERD and a surgical procedure less than 2 months ago, and the table marks that row DEFER.
Show the FAA's words: good to know, 4
C. Severe or Requiring surgical procedure less than 2 months ago or Recurrent procedure(s) … DEFER Submit the information to the FAA for a possible Special Issuance
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
Related conditions
Each has its own page, with what the FAA's documents say about it.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.