heart burn, acid taste, belching
pathophysiologies of GERD (4)
transient relaxation of LES
acid hypersecretion in stomach
decreased gastric emptying
atypical symptoms of GERD (5)
chest pain hoarseness dental enamel decay asthma/cough dyspepsia
GERD complications (3)
tx for unexplained angina or asthma?
when to perform GERD diagnostic?
what is the preferred GERD diagnostic?
uncertain diagnosis, atypical/complicated symptoms, refractory, before surgery
what can be seen with a barium swallow? what can’t?
yes: hiatal hernia, strictures
no: esophagitis, Barrett’s epithelium
what is the best study to confirm GERD?
ambulatory pH monitoring
what diagnostic study assesses LES pressure and peristalsis?
lifestyle tx for GERD (4)
elevate head of bed
no food 3h before bed
decrease fat and vol. of diet
H2 receptor anatagonists (4)
what is Barrett’s esophagus?
a specialized type of intestinal metaplasia- replacement of squamous epithelium with columnar epithelium due to recurrent acid injury
what is a result of Barrett’s esophagus?
progressive dysplasia while eating solid foods can indicate?
etiology of esophageal adenocarcinoma
odynophagia, constant chest/back pain, regurgitation, anorexia, wt. loss, malnutrition
most common type of esophageal cancer?
squamous cell carcinoma
risk factors for esophageal squamous cell carcinoma (4)
hx tobacco/EtOH use
ingestion of caustic substances
diagnosis of esophageal carcinoma? (2)
stage w/ CT