This document discusses the treatment of GERD and Barrett's esophagus. It outlines common symptoms of GERD like heartburn and difficulty swallowing. It also discusses potential complications like Barrett's esophagus and cancer if left untreated. The diagnosis involves medication trials and endoscopy. Barrett's esophagus is a pre-cancerous condition affecting the lining of the esophagus that requires surveillance and can be treated through lifestyle changes, medication, endoscopic procedures, or surgery with the goals of eliminating all abnormal cells and preventing progression to cancer while still requiring ongoing surveillance.

1. Normal

2. Treatment of GERD
Wilcotte C Rahming, M.D.
Oconee Medical Center

3. SYMPTOMS
• Heartburn
• Bleeding
• Pain while swallowing
• Difficulty swallowing
• Weight loss

4. COMPLICATIONS
• Barrett’s
• Erosion
• Obstruction from scarring
• Cancer

5. DIAGNOSIS
• Medication trial
• Endoscopy

6. Barrett’s Esophagus
• Affects the lining of the esophagus
• 3.3 million adults > 50
• Pre-cancerous
• 30-125 X >
• Incidence increase 6 fold

7. Barrett’s Esophagus
• 13% Caucasian men > 50
• 25% > 50 w/o Sx’s
• 44% adults have Sx’s monthly
• 18% weekly

8. Types
• IM with

12. SURVEILLANCE
• No dysplasia every 3 years
• LGD 6 - 12 months
• HGD every 3 months

13. TREATMENT
• Lifestyle change
• Medication
• Endoscopic
• Surgery

14. ENDOSCOPY
• RFA
• APC
• PDT
• CSA

15. GOALS
• Eliminate all IM
• Prevent progression NDBE/LGD to HGD
• HGD to cancer
• Complete eradication of BE
• Not to eliminate need for surveillance