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

Video Transcription

Video Summary

The video features Sorel Myberg, a nurse practitioner specialist in Rochester, Minnesota, who discusses the evaluation and management of gastroesophageal reflux disease (GERD). He covers topics such as the definition of GERD, symptoms, complications, diagnostic testing options, and treatment. Key points from the video include:<br /><br />1. Typical symptoms of GERD include heartburn and regurgitation. Focus on obtaining a detailed patient history to differentiate GERD from other conditions with similar symptoms.<br />2. Atypical symptoms may be seen in GERD and can be difficult to treat. They are often related to esophageal, pulmonary, or laryngeal issues.<br />3. GERD is common, affecting 10-20% of the population in the western world. It can impact a patient's quality of life and work productivity.<br />4. The pathogenesis of GERD is multifactorial, with various factors contributing to a failure in protective mechanisms.<br />5. Endoscopy is indicated in patients with alarm symptoms and long-standing symptoms, especially those over 50 years old. Grade C or D esophagitis requires starting patients on twice-daily PPI and re-evaluating with repeat endoscopy.<br />6. Testing options for GERD include Bravo pH monitoring, ambulatory pH and impedance monitoring, and manometry to assess esophageal motility.<br />7. Lifestyle modifications, such as weight loss, bed elevation, and avoiding meals before bedtime, are important in managing GERD.<br />8. Proton pump inhibitors (PPIs) are the mainstay of treatment for GERD. In some cases, H2 blockers may be used for breakthrough symptoms.<br />9. Surgical options, such as Nissen fundoplication and endoscopic procedures like TIF and LINX, may be considered for patients who do not respond to lifestyle modifications or medication therapy.<br />10. Long-term management of GERD involves using the lowest effective dose of acid suppression, considering PPI discontinuation when not needed, and monitoring for potential side effects.<br /><br />The video provides clinical pearls, polling questions, and expert discussions related to the evaluation and management of GERD.

Asset Subtitle

Sarel J. Myburgh APRN, CNP, MS

Keywords

GERD

symptoms

diagnostic testing

treatment

endoscopy

lifestyle modifications

proton pump inhibitors