This document provides an overview of gastroesophageal reflux disease (GERD). It defines GERD as reflux of stomach and duodenal contents into the esophagus, characterized by symptoms, radiologic or endoscopic changes. The pathogenesis involves transient relaxation of the lower esophageal sphincter, allowing acid reflux. Complications can include esophageal stricture, ulcer, or Barrett's esophagus, a precursor to esophageal cancer. Diagnosis is based on symptoms and testing may include pH monitoring or endoscopy to assess esophageal damage.
GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
GERD is the commonest GI problem afflicting the mankind. The cause is lax LES which is just opposite to Achalasia cadia. That is why GERD is also known as Chalasia cardia.
GERD is a day to day common problem, which is on the increase due to so many obvious reasons. It needs to be addressed to the public and the medical fraternity for proper management and treatment.
GERD (Gastro Esophageal Reflux Disease) is one of the commonest medical conditions found in the community today. GERD patients often suffer from frequent symptoms and require long term medication. However, how much of what we know about GERD is truly fact based on medical evidence? We challenge traditional paradigms to GERD
Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus.
Mr. Sankappa
Definition
Gastro esophageal reflux disease is a chronic and relapsing condition in which prolonged reflux of hydrochloric acid, pepsin and bile salts in the esophagus, oral cavity and respiratory system occurs that leads to esophagitis
Excessive intake of junk foods, coffee, chocolate
Excessive intake of onion, tomato, and beverages
Heavy exercise
Alcoholic and smoking
Medications
Heartburn
Discomfort
Chest pain
Difficulty in respiration
Aspiration pneumonia
After endoscopy the lesions are graded for severity using the Savary Miller grading system;
Grade 1: single or multiple erosions on a single fold.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential or rounded erosions.
Grade 4: ulcer, stenosis or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia (cellular changes on the microscopic level) in the form of circular or non-circular (islands or tongues) extensions.
Pathophysiology
Management
Antacids: An antacid is a substance which neutralizes stomach acidity, used to relieve heartburn, indigestion or an upset stomach (ex: Rantac, Zantac)
H2receptor antagonist: H2 antagonists block histamine-induced gastric acid secretion from the parietal cells of the gastric mucosa. They include cimetidine, famotidine, nizatidine
Proton Pump Inhibitors: Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid (Omeprazole, Rabeprazole, pantoprazole)
Cholinergic drugs:Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter (acetylcholine, carbachol, methacholine)
Cytoprotective drugs: is a process by which chemical compounds provide protection to cells against harmful agents (carbenoxolone, sucralfate, misoprostol)
Prokinetic drugs: prokinetic, is a type of drug which enhances gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. (Benzamide, Cisapride, Domperidone).
Endoscopic intraluminal valvuloplasty
Gastric tissue is utilised to increase the integrity of LES By creating a valve like structure.
Gastroesophageal Reflux Disease and Antireflux SurgeryHassan s1
this presentation describes the pathophysiology and presentation of gastroesophageal reflux disease. it also discusses the medical and surgical management of gastroesophageal reflux disease.. what makes this presentation unique is that it explains the short and long term effects of antireflux surgery and patient's satisfaction with this surgery with references.
Gastro esophageal Reflux Disease (GERD) and its managementDr. Ankit Gaur
In this presentation I have tried to explain in brief about gastro esophageal Reflux Disease (GERD), its etiology, risk factors, diagnosis, and its management via pharmacotherapy.
GERD is a day to day common problem, which is on the increase due to so many obvious reasons. It needs to be addressed to the public and the medical fraternity for proper management and treatment.
GERD (Gastro Esophageal Reflux Disease) is one of the commonest medical conditions found in the community today. GERD patients often suffer from frequent symptoms and require long term medication. However, how much of what we know about GERD is truly fact based on medical evidence? We challenge traditional paradigms to GERD
Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus.
Mr. Sankappa
Definition
Gastro esophageal reflux disease is a chronic and relapsing condition in which prolonged reflux of hydrochloric acid, pepsin and bile salts in the esophagus, oral cavity and respiratory system occurs that leads to esophagitis
Excessive intake of junk foods, coffee, chocolate
Excessive intake of onion, tomato, and beverages
Heavy exercise
Alcoholic and smoking
Medications
Heartburn
Discomfort
Chest pain
Difficulty in respiration
Aspiration pneumonia
After endoscopy the lesions are graded for severity using the Savary Miller grading system;
Grade 1: single or multiple erosions on a single fold.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential or rounded erosions.
Grade 4: ulcer, stenosis or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia (cellular changes on the microscopic level) in the form of circular or non-circular (islands or tongues) extensions.
Pathophysiology
Management
Antacids: An antacid is a substance which neutralizes stomach acidity, used to relieve heartburn, indigestion or an upset stomach (ex: Rantac, Zantac)
H2receptor antagonist: H2 antagonists block histamine-induced gastric acid secretion from the parietal cells of the gastric mucosa. They include cimetidine, famotidine, nizatidine
Proton Pump Inhibitors: Proton pump inhibitors (PPIs) reduce the production of acid by blocking the enzyme in the wall of the stomach that produces acid (Omeprazole, Rabeprazole, pantoprazole)
Cholinergic drugs:Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter (acetylcholine, carbachol, methacholine)
Cytoprotective drugs: is a process by which chemical compounds provide protection to cells against harmful agents (carbenoxolone, sucralfate, misoprostol)
Prokinetic drugs: prokinetic, is a type of drug which enhances gastrointestinal motility by increasing the frequency of contractions in the small intestine or making them stronger, but without disrupting their rhythm. (Benzamide, Cisapride, Domperidone).
Endoscopic intraluminal valvuloplasty
Gastric tissue is utilised to increase the integrity of LES By creating a valve like structure.
Gastroesophageal Reflux Disease and Antireflux SurgeryHassan s1
this presentation describes the pathophysiology and presentation of gastroesophageal reflux disease. it also discusses the medical and surgical management of gastroesophageal reflux disease.. what makes this presentation unique is that it explains the short and long term effects of antireflux surgery and patient's satisfaction with this surgery with references.
Gastro esophageal Reflux Disease (GERD) and its managementDr. Ankit Gaur
In this presentation I have tried to explain in brief about gastro esophageal Reflux Disease (GERD), its etiology, risk factors, diagnosis, and its management via pharmacotherapy.
Gastroesophageal reflux disease in children.Indian Society of Pediatric Gast...Vijitha A S
Gastroesophageal reflux disease in children.Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2022 update
DR VIJITHA A S
Gastroesophageal reflux disease (GERD) is defined as the failure of the antireflux barrier, allowing abnormal reflux of gastric contents into the esophagus. It is a condition which develops when the reflux of stomach contents causes troublesome symptoms and complications.
Dysphagia is an important problem in surgical patients. I have discussed Introduction, Zenker's diverticulum, GERD, Achalasia Cardia and Carcinoma Esophagus. If you watch all these videos together, i assure you that you will become confident in managing a case of dysphagia.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
16. The LA Classification system – Grade A reflux esophagitis Stomach Grade A : One (or more) mucosal break, no longer than 5 mm, that does not extend between the tops of two mucosal folds.
17. The LA Classification system – Grade B reflux esophagitis Stomach Grade B : One (or more) mucosal break, more than 5 mm long, that does not extend between the tops of two mucosal folds.
18. The LA Classification system – Grade C reflux esophagitis Stomach Grade C : One (or more) mucosal break that is continuous between the tops of two or more mucosal folds, but which involves less than 75% of the circumference.
19. The LA Classification system – Grade D reflux esophagitis Stomach Grade D : One (or more) mucosal break that involves at least 75% of the esophageal circumference.
31. TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE Step 1. Simple measures (lifestyle changes & nonsystemic treatment) A. Elevate head of bed B. Avoid food and fluid intake before bedtime C. Avoid cigarettes, coffee, alcohol D. Avoid chocolate, peppermint E. Avoid tight clothing around the waist F. Take antacids 1 hour after meals, at bedtime, and as needed G. Reduce fat in diet H. Lose weight Step 2. Measures for resistant cases (systemic treatment) Step 2a. H 2 -receptor antagonists A. Cimetidine, 300 mg q.i.d.* B. Ranitidine, 150 mg b.i.d.* C. Famotidine, 20 mg b.i.d.* D. Nizatidine, 150 mg b.i.d.* Step 2b. Prokinetic agents A. Metoclopramide, 10 mg q.i.d.* B. Cisapride, 10 mg q.i.d.* C. Bethanechol, 10 mg q.i.d.* Step 3. Measures for patients with GERD resistant to H 2 -receptor antagonists A. Proton pump inhibitor: omeprazole, 20 mg/day, or lansoprazole, 30 mg/day* Step 4. Measures for patients with GERD resistant to steps 1, 2, & 3 or patients who need long-term maintenance treatment A. Surgical fundoplication B.Endoscopic treatme
32. Endoscpic management of GERD: Endoscopic Baloon dilatation of esophageal stricture. Endoscopic photodynamic therapy, laser, or multipolar electrocoagulation ablasion of Barret esophagus. Endoscopic Radiofrequency application to LES. Laproscopic funduplication. Endoscopic antireflux stents.
36. Severe lingual tonsil hypertrophy Severe postglottic edema Arytenoid edema Tracheal cobblestoning carinal blunting
37.
38. I’m worried and concerned GI symptoms bother me! I cannot bend over or exercise Illustrator: Eric Werner My whole life is affected Heartburn disturbs my sleep I cannot eat and drink whatever I like