Hyperlipidemia Flashcards
(44 cards)
What is Gastroesophageal Reflux Disease (GERD)?
Symptoms or complications resulting from refluxed stomach contents into the esophagus, oral cavity (including the larynx) or lungs.
What are Extraesophageal Reflux Syndromes?
GERD symptoms associated with disease processes in organs other than the esophagus.
What is the most common age group affected by GERD?
Most common age: >40 years.
What percentage of adults in Western countries suffer from GERD symptoms weekly?
10% to 20%.
What substances are involved in GERD?
Gastric Acid, Pepsin, Bile Acids, Pancreatic Enzymes.
What are common symptoms of GERD during pregnancy?
Reflux and heartburn are common in pregnancy complications from long-term acid reflux.
What are the risk factors and comorbidities associated with GERD?
Family History, Smoking, Alcohol Consumption, Obesity, Certain Medications and Foods, Respiratory Diseases, Reflux Chest Pain Syndrome.
What is Barrett’s esophagus?
Increased risk of esophageal adenocarcinoma.
What are typical esophageal symptoms of GERD?
Heartburn, Belching, Chest Pain. Aggravated by bending over or high fat meals.
What are alarm symptoms indicative of serious conditions in GERD?
Dysphagia, Odynophagia, Bleeding, Unexplained Weight Loss.
What types of esophageal tissue injury can occur due to GERD?
Esophagitis, Strictures, Barrett’s Esophagus, Esophageal Adenocarcinoma.
What are extraesophageal symptoms of GERD?
Chronic cough, Laryngitis, Asthma, Wheezing.
What are the goals of GERD treatment?
To reduce or eliminate symptoms, decrease frequency and duration of gastroesophageal reflux, promote healing of injured mucosa, prevent development of complications.
What is the recommended approach for GERD treatment?
A step-down approach starting with a PPI instead of an H2RA, and then stepping down to the lowest dose of acid suppression needed to control symptoms.
What does the general approach to GERD treatment include?
Lifestyle changes, patient-directed therapy with antacids and/or nonprescription acid suppression therapy (H2RAs and/or PPIs), pharmacologic treatment with prescription-strength acid suppression therapy, Anti-Reflux Surgery.
What are the components of pharmacologic treatment for GERD?
H2 Receptor Antagonist, Proton Pump Inhibitor, Promotility Agents, Mucosal Protectant, Combination Therapy.
What is combination therapy in GERD treatment?
Acid Suppression Agent + Promotility Agent or Mucosal Protectant. Not recommended unless a patient has GERD with motor symptoms.
What is maintenance therapy for GERD?
Long term therapy should be considered to prevent complications and worsening of esophageal function in patients who have symptomatic relapse after therapy discontinuation or dosage reduction.
What lifestyle modifications are recommended for GERD?
Elevate head of the bed, weight reduction, avoid foods that decrease LES pressure, include protein-rich meals, avoid irritant foods, avoid alcohol and smoking, avoid tight-fitting clothes, eat small meals, and take medications that irritate the esophageal mucosa in an upright position.
What is the anti-reflux surgery procedure for GERD?
Nissen Fundoplication: Re-establish the anti-reflux barrier, repair hernia, reposition sphincter, recreate a flap valve.
What are the candidates for anti-reflux surgery?
Poor compliance, adverse effects, symptomatic with large hiatal hernia, abnormal pH test while on max. PPI dose.
What are the complications of anti-reflux surgery?
Inability to vomit, dysphagia, diarrhea, chest pain.
What are the considerations for typical GERD patients?
Higher doses and longer treatment courses, suspected reflux chest pain syndrome - PPI BID for 4 weeks, pH monitoring if symptoms continue.
