GERD Flashcards
Heart Burn
Burning sensation,
within 1 hour after eating, especially after a large meal or ingestions of offending foods/and or beverages
GERD
Heartburn, acid regurgitation
Stomach or lower chest that rises up toward the neck occasionally to the back
Dyspepsia
postprandial fullness, early satiation, epigastric pain, epigastric burning
bloating, NV and bleching may accompany but are not specific
epigastric area
PUD
Peptic ulcer disease
Gnawing or burins epigastric pain, occurring during the day and frequently at night; may be accompanied by heart burn and dyspepsia
2-5 hours after meals, between 11pm and 2 am
Dietary contribution
Fatty foods Spicy foods Chocolate Salt and salt substitutes Caffeinated or carbonated beverages Citrus fruits or juices Tomatoes/tomato juice
Lifestyle
contritbution
Exercise Smoking Obesity Stress Laying down after eating Tight-fitting clothing
Diseases
contribution
Motility disorders (e.g. gastroparesis)
Scleroderma -rare disease that causes the hardening and tightening of skin
PUD (peptic ulcer disease)- painful sores or ulcers in the lining of the stomach
Zollinger-Ellison syndrome- disease in which tumors cause the stomach to produce too much acid, resulting in peptic ulcers
Medication contribution
Bisphosphonates Aspirin/NSAIDs Iron Potassium Quinidine Tetracycline Zidovudine Anticholinergic agents Calcium channel blockers Alpha/Beta adrenergic agonists Progesterone Chemotherapy
GERD and PUD
automic referral
GERD Alarm system
Dysphagia (difficulty swallowing) Odynophagia (painful swallowing) Chest pain Upper GI bleeding Unexplained weight loss Continuous nausea, vomiting, and diarrhea
PUD alarm system
Upper GI bleeding
Unexplained weight loss
Continuous nausea, vomiting, and diarrhea may occur
non pharm
Dietary and lifestyle modification
Avoid medications that may aggravate symptoms
Avoid eating large meals
Stop/reduce smoking
If symptoms at night:
Avoid lying down within 3 hours of a meal
Elevate the head of the bed
Antacids
Aluminum
Magnesium
calcium carbonate
sodium bicarbonate
-Brand examples are Alka-Seltzer, Tums, Milk of Magnesia
Neutralizes stomach acid or for mild infrequent heartburn
Quick relief. Can take on an empty stomach or after meal
H2RAs
Cimetidine
Ranitidine
Famotidine
Nizatidine
-Brand examples are Pepcid, Tagamet, Zantac
Not as rapid onset as antacids, but longer duration of relief
Cimetidine is the shortest-acting (4-8 hours of relief) whereas ranitidine, famotidine, and nizatidine have a somewhat longer duration
tolerance my develop
Take 30 minutes before eating
Okay to use with anyone >12 years old
PPIs (proton pump inhibitor)
Omeprazole
Lansoprazole
Esomeprazole
-Brand examples are Prilosec, Prevacid, Nexium
For the treatment of FREQUENT heartburn in patients who have symptoms 2 or more days a week.
Complete relief may take 1-4 days
Most effective when taken 30-60 min before a meal
Okay to use with anyone >18 years old
