GERD

Question 1

Excessive reflux of gastric content into the esophagus “heartburn”

Answer 1

GERD

Question 2

What is payrosis?

Answer 2

medical term for heartburn

Question 3

What are the causes?

Answer 3

Decreased LES tone
Decreased esophageal motility to clear refluxed fluid
Gastric outlet obstruction
Hiatal hernia in 50% of px

Question 4

What are the symptoms?

Answer 4

Heartburn
regurgitation
respiratory problems/pneumonia from aspiration of gastric contents
substernal pain

Question 5

What disease must be ruled out?

Answer 5

CAD

Question 6

What tests are included int the workup?

Answer 6

EGD
UGI contrast with esophagogram
24-hour acid analysis
Manometry

Question 7

What is the medical treatment

Answer 7

Small meals
PPI, H2 blocker
Elevation of head at night and no meals prior to sleeping

Question 8

Indications for surgery

Answer 8

Intractability (failure of medical mgt)
Repsiratory problems
Sever esophageal injury

Question 9

What is Barrett’s esophagus?

Answer 9

Comumnat metaplasia from the normal squamous epithelium as a result of chronic irritation from reflux

Question 10

What is the major concern with Barrett’s esophagus?

Answer 10

Devaloping cancer

Question 11

What type of cancer develops?

Answer 11

AdenoCA

Question 12

% of GERD developing BE

Answer 12

10%

Question 13

% of BE developing AdenoCA

Answer 13

7% liftime

Question 14

Treatment of BE with dysplacia

Answer 14

Nonsurgical: mucosal resection

Question 15

360 deg funoplication - 2cm long

Answer 15

Nissen fundoplication

Question 16

240-270 deg

Answer 16

Belsey mark IV

Question 17

Incomplete 200deg

Answer 17

Toupet

Question 18

Post operative complications of Lap Nissen

Answer 18

Gas bloat syndrome
Stricture
Dysphagia
Spleen injury requiring splenectomy
Esophageal perforation
Pneumothorax

Question 19

Wha tis gas-bloat syndrome

Answer 19

inability to burp or vomit