Stomach

Question 1

1. GERD with presence of Alarm symptoms ( Hx of gastric CA, IDA, Weightloss)?
2. Treatment for GERD with mild symptoms < 2x week ?
3. Treatment of GERD with severe symptoms > 2x a week?
4. Next step in management when a patient is not getting relief in symptoms with GERD when taking PPI once daily? and Why?
5. Whats the next step if that doesnt improve ?

Answer 1

1. Endoscopy
2. Anti-acids (Calcium Carbonate, H2 blocker
3. PPI

4.Increase twice daily to help with breakthrough nighttime symptoms. Morning and night

5. Esophageal pH monitoring and Upper Endoscopy to rule out other causes.

Question 1

3 common causes of Gastroparesis?

First diagnostic test for suspected Gastroparesis ?

Answer 1

1. Post Viral (Norwalk Virus)
2. DM
3. Medications

Do Upper Endoscopy first - shows visible retained food

Emptying studying will see > 10% of the tracer left in stomach after 4 hrs.