ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-Based Learning (Day Two) | March 2024-GERD, Barrett’s Esophagus and Barrett’s Endotherapy

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This document provides a summary of the information presented in a course on GERD (gastroesophageal reflux disease), Barrett's esophagus, and Barrett's endotherapy. The course was conducted in April 2024 by Dr. Vivek Kaul, an expert in the field.<br /><br />GERD, also known as acid reflux, affects 10-20% of the population, with symptoms including heartburn, reflux, and dysphagia. It is equally prevalent in males and females, but there is an increased risk of esophagitis in males over 40 years old who are smokers. Typical symptoms include heartburn and regurgitation, but atypical symptoms such as uncontrolled asthma, cough, and throat clearing can also be present.<br /><br />The diagnosis of GERD is based on symptoms and can be confirmed through various tests, including pH testing, manometry, and endoscopy. Treatment options include lifestyle modifications (such as weight loss and avoiding trigger foods), medications (such as proton pump inhibitors), and surgical interventions for those who do not respond to medical management.<br /><br />Barrett's esophagus is a condition in which the lining of the lower esophagus is replaced by a type of tissue called specialized intestinal metaplasia. It is considered a precancerous condition with an annual risk of progression to esophageal adenocarcinoma of 0.3% per year. Risk factors for Barrett's esophagus include GERD symptoms for more than 5 years, age over 50, male gender, tobacco usage, central obesity, and Caucasian race.<br /><br />Screening and surveillance are important for detecting dysplasia or early cancer in Barrett's esophagus. Treatment options include endoscopic eradication therapy (such as radiofrequency ablation, cryotherapy, and endoscopic mucosal resection) and surgical interventions for advanced cases.<br /><br />Newer devices, such as swallowable capsules for screening and surveillance, are being developed. The multidisciplinary team approach, involving experts in endoscopy, surgery, pathology, and nursing, is recommended for the management of Barrett's esophagus.<br /><br />The role of advanced practice providers (APPs) in Barrett's practice is highlighted, including their involvement in initial evaluation, peri-procedure management, recognition of contraindications to therapy, adherence to guidelines, and participation in clinical research.<br /><br />In summary, this course provided an overview of GERD, Barrett's esophagus, and their management, including diagnosis, treatment options, and the role of endoscopic and surgical interventions.

Asset Subtitle

Vivek Kaul, MD, FASGE

Keywords

GERD

gastroesophageal reflux disease

Barrett's esophagus

Barrett's endotherapy

Dr. Vivek Kaul

acid reflux

esophagitis

endoscopic eradication therapy

Barrett's practice

specialized intestinal metaplasia