ICS-Heartburn

Question 1

What are the most common presentations of GERD?

Answer 1

Pyrosis, sourbrash, belching, bloating, dysphagia, halitosis, chronic cough, chronic laryngitis

Question 2

What are risk factors for GERD?

Answer 2

BMI, Alcohol, Caffeine, Pregnancy, Hiatal hernia, Chocolate, Peppermint, NSAIDs

Question 3

Why are pregnant women at increased risk for GERD?

Answer 3

Lower esophageal sphincter tone, hiatal hernia and decreased peristalsis.

Question 4

What observational findings are indicative of GERD?

Answer 4

Loss of tooth enamel, hoarseness

Question 5

What do you absolutely not want to miss in a patient presenting with classic GERD symptoms?

Answer 5

Coronary artery disease (unstable angina), aortic dissection, esophageal cancer

Question 6

What lifestyle changes help manage GERD?

Answer 6

Elevate head of bed, weight loss and avoid known triggers

Question 7

What medications are used to treat GERD?

Answer 7

Antacids, H2 blockers, PPIs

Question 8

Medications with tachyphylaxis

Answer 8

H2 blockers. They stop working over time, but work again after taking a break from using them.

Question 9

What are indications for endoscopy in patients with GERD?

Answer 9

Dysphagia, odynophagia, bleeding, anemia, unexplained weight loss, not responsive to PPIs

Question 10

What are indications for surgery in patients with GERD?

Answer 10

Medication tolerance