GERD

Question 1

What is the endoscopic tx for GERD?

Answer 1

• Radio-frequency energy (the Stretta method)(hypertrophy to close gap)

• Suturing the gastroesophageal junction by means of endoscopy.

Question 2

Surgical indications for GERD?

Answer 2

• Patients whose esophageal symptoms are relieved by antacids but cannot tolerate antacids
• Dose increase/ need to take medication for a long time/ unwillingness to take medication or drug-related side effects
• Structurally damaged LES (hiatal hernia)
• Patients with persistent nocturnal symptoms—-Regurgitation
• Patients with extraesophageal symptoms
• Patients who developed:
• Barret esophagus, stricture, bleeding
• Patients with frequent recurrence
• Type 2-3-4 hiatal hernia

Question 3

What is the clinical word for pyrosis?

Answer 3

Heartburn

Question 4

What are the Atypical Esophageal and GIS symptoms of GERD?

Answer 4

[BOF,NEH]
Burping

Odynophagia(painful swallowing)

Fullness in chest

Nausea-vomiting

Epigastric pain

Hiccup

Halitosis(bad mouth smell)

Back pain

Question 5

What are the respiratory related symptoms of GERD?

Answer 5

Chronic cough-Sore throat

-Asthma
-sleep apnea
-chronic bronchitis
-aspiration pneumonia
-pulmonary fibrosis

Question 6

What are the dx method for GERD?

Answer 6

**Esophageal manometry
**24hr pH monitoring
-Endoscopy
-ppi (proton pump inhibitor—>dec H+)