GERD

Question 1

What is the pertinent anatomy of GERD?

Answer 1

Esophagus

Question 2

What plays a vital role in the frequency and severity of GERD?

Answer 2

Lower Esophageal Sphincter

Question 3

What are some complicaitons of GERD?

Answer 3

Barrett Esophagus a condition in which the epithelium of the esophagus is replace dby metaplastic columnar epithelium containing goblet and columnar cells
present in up to ten percent of patients with chronic reflux
arises from chronic reflux inducred injury to esophageal squamous epithelium
does not provoke specifi sytmtoms

Question 4

What is peptic stricture?

Answer 4

Occurs in about five percent of patients with gerd. manifested by the gradual development of solid food dysphagia progressive over months to years. often there is a reduction in heartburn because the stricture acts as a barrier to reflux.
most strictures are located at the gastroesophageal junction

Question 5

How do you treat GERD?

Answer 5

Mild, intermittent symptoms, life style modifications
weight loss should be recommended for overweight patients
advise patients not to lay down with in three hours of eating
elevate the head of the bed on 6 inch blocks or a foam wedge to reduce reflux

Question 6

What is the dosage for H2 blockers?

Answer 6

Famotidine 20-40 mg PO bid

Question 7

What is the dosage for PPIs?

Answer 7

Omeprazole 20 mg PO daily
Pantoprazole 20 mg PO daily
Esomeprazole 40 mg daily