Enfermedad de reflujo gastroesfagico

Question 1

Epidemiologia:

Answer 1

a. Approximately 10% of adults have GERD daily.
b. Approximately 80% of pregnant women have GERD.
c. Hiatal hernia present in ~70% of people with GERD.

Question 2

Factores de riesgo:

Answer 2

(1) Smoking, alcohol
(2) Caffeine, fatty foods, chocolate
(3) Pregnancy, obesity
(4) Hiatal hernia

Question 3

Patogenia:

Answer 3

a. Transient relaxation of lower esophageal sphincter (LES)
• Reflux of acid and bile into the distal esophagus
b. Ineffective esophageal clearance of reflux material

Question 4

Hallazgos Clinicos:

Answer 4

a. Noncardiac chest pain
• Heartburn, indigestion
b. Nocturnal cough, nocturnal asthma
c. Acid injury to enamel
d. Early satiety, abdominal fullness
e. Bloating with belching
f. Barrett esophagus

Question 5

Tests diagnósticos con presentación atípica?

Answer 5

a. Esophageal pH monitoring for 24 hours
• Sensitivity/specificity 80% to 90%
b. Esophageal endoscopy
c. Manometry
• LES pressure

Question 6

Tratamiento:

Answer 6

a. Nonpharmacologic
• Similar to hiatal hernia (see earlier)
b. Pharmacologic
• Similar to hiatal hernia (see earlier)
c. Surgery if indicated
(1) Fundoplication procedure
(2) Involves putting a gastric wrap around the gastroesophageal junction