gastrointestinal reflux Flashcards

1
Q

what is the montreal definition for GERD?

A

a condition which develops when the reflux of gastric content cause troublesome symptoms or complications

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2
Q

what are the typical symptoms of GERD?

A

heartburn

regurgitationn n

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3
Q

what are the atypical symptoms of GERD ?

A

-non-cardiac chest pains
-hoarsness and chronic cough
-asthma,pulmonary fibrosis
hiccups, dental erosion

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4
Q

what are the complications of GERD?

A

esophageal erosion and/or ulcers
strictures
barret’s oesophagus
oesophageal adenocarcinoma

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5
Q

what to do once a patient present with symptoms of reflux disease ?

A

prescribe PPI

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6
Q

after administration of PPI , if symptoms persist what is the next step in management ?

A

perform an endoscopy

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7
Q

Based on the results of the endoscopy what is the next step in management ?

A

if the endoscopy is normal then pH monitoring is required along with manometry

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8
Q

what is NERD ?

A

non erosive reflux disease also called endoscopy negative disease

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9
Q

what is a sign that can be used to confirm diagnosis of GERD?

A

show improvement of symptoms to PPI

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10
Q

what are the indications for performing n endoscopy ?

A

1- failure of PPI therapeutic trial
2- patients with alarming features at presentation
3- patients previously endoscoped known to have grade C or D GERD
4- patients older than 50 years with risk factors for barrett’s oesophagus or oesophageal adenocarcinoma
5- chronic patients who report unusual disappearance of HB

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11
Q

what are the different grades of reflux oesophagitis ?

A

grade A : one or more mucosal breaks no longer than 5 mm that doesn’t extend between the twoo mucosal folds

Grade B : one or more mucosal break, more than 5mm loong that does not extend between the tops of two mucosal breaks

Grade C : mucosal breaks less than 75 % of the circumference , breaks are continuous between the tops

Grade D: one or more mucosal break that involves more than 75% of the esophageal circumference

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12
Q

what is the most prevalent grade of esophagitis ?

A

grade B

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13
Q

what is the gold standard for the diagnosis of GERD?

A

ambulatory 24 hr pH studies

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14
Q

step down vs step up approach ?

A

step down is proven to be better where you start with PPI instead of antacids

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15
Q

do GERD patients need long life treatment ?

A

there must be a trial to stop PPI except in grade C and grade D

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16
Q

what type of carcinoma is associated with GERD ?

A

barrett’s oesophagus

17
Q

what can be used for barrett’s screening ?

A

chromoendoscopy