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Gerd
This document provides an overview of gastroesophageal reflux disease (GERD). It discusses the epidemiology and risk factors for GERD. It describes the pathophysiology of GERD including disruption of anatomical barriers like the lower esophageal sphincter and factors that increase acid exposure in the esophagus. The document outlines the clinical manifestations of GERD including typical symptoms and complications. It reviews diagnostic tests for GERD and discusses approaches to management including lifestyle modifications, medications like PPIs, and surgical options for severe or refractory cases.
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Editor's Notes
- #4 GER itself not a disease amd occurs multiple times each day without symp or mucosal damage.. 2009 in us 8.9 million outpatient visit for GERD
- #5 accurate prevalence rates for GERD is difficult to ascertain because many affected pt even those with barrets esophagus have no symptoms. objective tests such as endoscopy (esophagitis) and esophageal Ph testing is impractical in large screening populn.
- #10 rarely cause of death, considerably morbidity and complications
- #16 rarely cause of death, considerably morbidity and complications
- #18 ALTHOUGH clearance mechanism minimize acid contact time with the epithelium, even healthy subjects have acid reflux symp. only few suffer GER and even fewer GERD due to third tier Tissue resistance. subdivided preepithelial, epithelial and post epithelial factors
- #22 reporting a burning feeling, rising from the stomach or lower chest and radiating toward the neck, throat, and occasionally the back.postprandi_x0002_ally, particularly after large meals or after ingesting spicy foods, citrus products, fats, chocolates, and alcohol. The supine position and bending over may exacerbate heart_x0002_burn.When heartburn dominates a patient’s com_x0002_plaints, it has high specificity (89%) but low sensitivity (38%) for GERD as diagnosed by 24-hour esophageal pH testing
- #64 esophageal lumen diameter less than 13 mm, dysphagia occurs and esophageal dilations required.