GERD pg 2195

Question 1

difference between pathologic and physiologic GERD?

Answer 1

Pathologic is associated with sx of mucosal injury and often occurs nocturnally.

Question 2

Pain associated with GERD is secondary to what?

Answer 2

stimulation and activation of mucosal chemoreceptors by acid

Question 3

what foods exacerbate sx of GERD

Answer 3

spicy, acidic, salty foods and alcohol.

Question 4

Sx of GERD

Answer 4

heartburn 30-60 mi after meal upon bending or reclining
relief from antacids or baking soda
regurgitation
dysphagia

Question 5

contributors to dysphagia in GERD patients

Answer 5

erosive esophagitis, abnormal esophageal peristalsis, esophageal stricture.

Question 6

what are some extraesophageal manifestations of GERD:

Answer 6

asthma
chronic cough
laryngitis
sore throat
non cardiac chest pain

Question 7

complications of GERD:

Answer 7

barret esophagus. present in 10% of patients with GERD. epithelium cells replaced by metaplastic columnar epithelium containing goblet and columnar cells.

peptic stricture- 5% of patients. progression of solid food dysphagia over months or years. accompanied, usually, with reduction of heartburn sx. located at gastroesophageal junction

Question 8

when would you use endoscopy with GERD patients?

Answer 8

only complicated cases.

Question 9

Treatment of GERD:

Answer 9

lifestyle modifications (smaller meals, less acidic foods, fatty foods…etc)
weightloss
avoid lying down 3 hours after meals.
bed on blocks
antacids

Question 10

treatment of choice for GERD

Answer 10

PPI. (e.g. omeprazole, pantoprazole…)

Question 11

when should you refer patients with GERD:

Answer 11

no resolution with maximum empiric therapy of 2x a day PPI.
significant dysphagia
barrett esophagus or stricture