What is the basic mechanism of antacids?
Act as a buffer on acid in the stomach
What is achalasia?
Loss of peristalsis in the distal esophagus
Failure of Lower esophageal sphincter relaxation with swallowing
All patients with GERD should elevate head of bed (T/F)
False - Only patients with nocturnal symptoms
How will a barium swallow appear in a patient with achalasia?
Bird-beak appearance - caused by persistently contracted LES
What is pill induced esophageal injury?
What are some of the mechanisms of GERD?
Defective esophageal clearance
Delayed gastric emptying
Increased intra-abdominal pressure
What is the treatment of eosinophilic esophagitis?
6 point elimination diet
What is Schatski's ring?
Draw a flow chart that characterize the different types of heartburn
What are the extraesophageal manifestations of GERD?
GERD patients should lose weight (T/F)
True - increased intraabdominal pressure is found to be in close correlation with GERD
Cimetidine, Rantidine, and Famotidine are what types of drugs?
Histamine Receptor Antagonists
What is eosinophilic esophagitis?
Allergic inflammation of the esophagus - high eosinophil count
PPI does not help
What is Barrett's esophagitis?
This is a metaplastic reaction that results in the change of the esophageal squamous epithelium to columnar
What are the symptoms of achalasia?
Progressive dysphasia for solids and liquids
What is a peptic stricture?
Scar tissue that has formed from chronic inflammation
In normal patients what is the cause of stomach acid in the esophagus for short periods of time?
Transient lower esophageal relaxation
What is GERD defined as?
Defined as symptoms or complicaton resulting from the reflux of gastric contents in the esophagus
Atypical reflux symptoms respond well to treatment (T/F)
False - heartburn and regurgitation respond well
What is esophageal hypersensitivity?
Patients that are sensitive to physiologic amounts of acid
Patients tend to respond to high levels of PPIs
Omeprazole is what type of drug?
Proton pump inhibitor
What is NERD?
Non erosive reflux disease
The response to proton pump inhibitors is less in NERD than GERD
Draw a flow chart of treatment of acid reflux
All patients with GERD should change diet (T/F)
False - no supporting evidence
PPIs can have what side effects?
Increased risk of CKD
GERD puts a patient at increased risk of?
What is the endoscopic appearance of eosinophilic esophagitis
What are the different classifications and management of Barrett's?