GERD, Esophagitis, and Gastrointestinal Dysmotility

Question 1

What are patient complaints of GERD?

Answer 1

1. Midsternal Burning
2. Food feels like it is coming back up
3. Burning may last up to 2 hrs

Question 2

What are the treatment options for GERD?

Answer 2

1. H2RAs
2. PPIs
3. Antacids
4. Sucralfate
5. Prokinetic Agents (ADJUNCT)

Question 3

What are antacids used for in GERD?

Answer 3

Not useful for prophylaxis, best for PRN and infrequent symptoms

Question 4

What is Sucralfate used for in GERD?

Answer 4

Not efficacious, sometimes used in pregnancy

Question 5

What is H2RAs used for in GERD?

Answer 5

H2RA<PPI
Grade 1 and 2

Question 6

What is PPIs used for in GERD?

Answer 6

PPI> H2RAs
Gold standard
Grade 3 and 4

Question 7

What is Prokinetics used for in GERD?

Answer 7

ADJUNCT, refractory symptoms

Question 8

What is first line therapy for intermittent symptoms?

Answer 8

1. TLC +
2. PRN Antacid
3. PRN H2RA

Question 9

What is first line therapy for persistent symptoms or mild esophagitis?

Answer 9

1. TLC +
2. Standard H2RA OR
3. Standard PPI

Question 10

What is first line therapy for severe symptoms or moderate/severe esophagitis?

Answer 10

1. TLC +
2. Standard PPI

Question 11

What are the common causative agents of Pill Induced Esophagitis?

Answer 11

1. Antibiotics (tetracyclines)
2. Antivirals
3. ASA
4. NSAID
5. Bisphosphonates (Alendronate/Pamidronate)
6. Potassium Preparations
7. Quinidine
8. Ferrous Sulfate or Succinate