Reflux and Esophageal Disease

Question 1

Define GERD:

Answer 1

symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus

Question 2

Diagnosis criteria for GERD

Answer 2

heartburn two or more times a week

Question 3

What are the causes of GERD?

Answer 3

lower esophageal sphincter relaxation and reduced resting pressure

Question 4

What are the aggressive factors in GERD?

Answer 4

gastric acid, pepsin, bile acids, and pancreatic enzymes

Question 5

What are the defensive mechanisms in GERD?

Answer 5

1. Lower esophageal sphincter pressure

2.

Question 6

What are the typical symptoms of GERD?

Answer 6

1. heartburn
2. regurgitation
3. belching
4. dyspepsia
5. epigastric pain & nausea

Question 7

What are the extraesophageal symptoms?

Answer 7

1. cough
2. asthma
3. laryngitis
4. chest pain
5. dental erosions

Question 8

What are the alarm symptoms?

Answer 8

1. dysphagia
2. odynophagia
3. unexplained weight loss
4. bleeding
5. anemia
6. choking
7. continual pain despite therapy

Question 9

How is GERD most commonly diagnosed?

Answer 9

Symptoms (trial PPI and look for resolution)

Question 10

When should a pt be referred for an endoscopy?

Answer 10

1. age > 45
2. alarm symptoms
3. refractory to tx
4. pre-op assessment

Question 11

What are three major consequences of GERD?

Answer 11

1. esophagitis
2. development of strictures
3. Barrett’s esophagus

Question 12

What is Barrett’s esophagus?

Answer 12

A precancerous condition caused by prolonged GERD