ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand) | April 2022-17_Evaluation of Patient with GERD

17_Evaluation of Patient with GERD - Myburgh

Pdf Summary

This document discusses the evaluation and management of Gastroesophageal Reflux Disease (GERD). It provides an overview of what GERD is, its symptoms, complications, diagnostic tests, and treatment options. Typical symptoms of GERD include heartburn and regurgitation, while atypical symptoms can involve the lungs, throat, and oral health. GERD is prevalent in 10-20% of the Western population and can significantly impact quality of life. Complications of GERD include peptic strictures, Schatzki's ring, bleeding/iron deficiency, Barrett's esophagus, and esophageal adenocarcinoma. <br /><br />Several diagnostic tests for GERD are discussed, including upper endoscopy, pH monitoring, and impedance monitoring. Initial management of GERD often involves an empiric trial of acid suppression therapy. Proton pump inhibitors (PPIs) are the primary treatment, with symptom response typically seen within 1-2 weeks. The management of GERD varies depending on the severity and presence of complications. Surgical options, such as Nissen and Toupet/Belsey fundoplication, may be considered for certain cases. <br /><br />The long-term use of PPIs carries some risks, such as interactions with other medications, bone fractures, C. difficile infection, and nutrient deficiencies. When using PPIs, it is recommended to use the lowest effective dose and consider H2 blocker therapy when PPIs are not needed. Laboratory testing is not routinely recommended, but periodic monitoring of creatinine, B12 levels, and magnesium levels may be considered. <br /><br />The document also includes clinical pearls for managing GERD and provides polling questions to test the reader's knowledge on appropriate management decisions for specific patient scenarios.

Keywords

GERD

symptoms

complications

diagnostic tests

treatment options

acid suppression therapy

proton pump inhibitors

surgical options

risks

H2 blocker therapy