GERD and complications Flashcards
What are protective factors against gerd
ge reflux barrier
esophageal clearance
mucosal resistance
what are causative factors of gerd
gastric acid and pepsin
duodenal contents
increased gastric volume
increased abd pressure
what is the relationship in incidence of gerd and h pylori
increased rates of gerd with h pylori tx
how does the crural diaphragm affect gerd?
it has a sphincteric action on esophagus
what is the resting pressure of a health les?
10-30
when do you commonly see a reduce les pressure?
severe esophagitis, pregnancy, peppermint, fat, chocolate
What is a hiatal hernia?
a piece of stomach is about the crural diaphragm, reducing one of the protective barriers against acid reflux
Why is gerd worse at nighttime?
decreased effects of gravity, lower levels of salivation, which triggers peristalsis of the gi system
What are the primary symptoms of gerd
heartburn radiating up to neck, worse after meals and lying flat
regurg
dysphia (strictures from scarring or cancer)
what are associated symptoms of gerd
belching, hiccups, water brash, reflux laryngitis
What meds should you avoid in gerd
anticholinergics,
what meds are used to tx gerd?
antacids, histamine-2 receptor blockers, ppi
What is the pathophys of barrett’s esophagus?
consequence of chronic GERD
damage to squ epi leads to healing through metaplastic process leads to replacement by columnar epithelium
where is the z-line in barrett’s esophagus?
above GEJ
what are txs of barretts?
radioablation, surgery
