Clinical- GERD Flashcards
What is the most common cause of non-cardiac chest pain?
reflux
Patients with what respiratory condition must you consider reflux?
Asthma
What is the first test u have to do for GERD?
EGD
What is the first medication you give to treat GERD and rule it out?
a proton pump inhibitor (PPI)
A definitive Dx of GERD is made by seeing what on an EGD?
Esophagitis
White men > 50 y/o with reflux > 5-7 years should be checked for what condition?
Barrett’s (w/dysplasia for adenocarcinomas)
How often should you screen for dysplasia in Barretts if there is no dysplasia on 2 EGD’s in 1 year?
every 3 years
If there is low grade dysplasia on EGD, when should u repeat the EGD?
within 6 months
If there is presence of high grade dysplasia, when should you re-do the EGD to rule out malignancy?
in 3 months
What treatments can u give to a pt if there is a presence of high grade dysplasia?
esophagectomy (surgery) or photodynamic therapy
If you do a EGD to Dx GERD but there is no esophagitis, what other test can you do to Dx reflux?
24-hour intraesophageal pH monitoring
This test is reserved for patients with suspected esophageal motility disorders or preop evaluation of surgical cadidates.
Esophageal manometry
When is the best time to take a PPI?
30-60 minutes BEFORE a meal.
Younger patients who respond well to PPI therapy but want to avoid lifelong treatment can consider what?
antireflux surgery
What is the surgery for severe GERD called?
nissen fundoplication
