Gastroesophageal Reflux Disease

Question 1

GERD Dx

Answer 1

based on CxFx: epigastric burning pain radiating up into
the chest.”
+- sore throat, bad taste in the mouth (metallic),
hoarseness, or cough. Nocturnal ASTHMA**

Dx can be based on PPI treatment, empirically

Question 2

In some patients in whom the diagnosis is not clear, this test is done to confirm the etiology.

Answer 2

24-hour pH

Question 3

When to use Endoscopy

Answer 3

Signs of obstruction such as dysphagia or odynophagia
Weight loss
Anemia or heme-positive stools
More than 5–10 years of symptoms to exclude Barrett esophagus

Question 4

GERD Endoscopy

Answer 4

redness, erosions, ulcerations, strictures, or Barrett

esophagus

Question 5

GERD Measures along medication

Answer 5

• Lose weight if obese.
• Avoid alcohol, nicotine, caffeine, chocolate, and peppermint.
• Avoid eating at night before sleep (within 3 hours of bedtime).
• Elevate head of bed 6 to 8 inches.

Question 6

GERD mild or intermittent symptoms Tx

Answer 6

liquid antacids or H2

blockers. tho not in ONLINEMEDED

Question 7

Persistent Symptoms or Erosive Esophagitis Tx

Answer 7

PPIs .6week*****+Life style

Question 8

Treatment of Those Not Responsive to Medical Therapy

Answer 8

• Nissen fundoplication:
• Endocinch: .
• Local heat or radiation of LES

Question 9

Barrett Esophagus Dx

Answer 9

biopsy.

Columnar metaplasia greatest risk of transforming into EsophCA

Question 10

Barrett alone

(metaplasia) Tx

Answer 10

PPIs bid and rescope every 2–3 years

Question 11

Low-grade

dysplasia Tx

Answer 11

PPIs and rescope every 6–12 months. tho online med says it is different for all dysplasia

Question 12

High-grade

dysplasia Tx

Answer 12

Ablation with endoscopy:

• photodynamic therapy,
• radiofrequency ablation,
• endoscopic mucosal resection,
• cryo.