ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-based Learning (Day Two) | March 2025-GERD, Barrett’s Esophagus, and Barrett’s Endotherapy

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The text presents a comprehensive examination of Gastroesophageal Reflux Disease (GERD) and Barrett's Esophagus, as shared by Sarel Myburgh, APRN, CNP, at the ASGE Annual GI Advanced Practice Provider Course in 2025. By providing an overview of GERD, its occurrence, and associated complications, the presentation outlines methods for diagnosis, management, and treatment. <br /><br />**GERD Overview:**<br />GERD affects about 10-20% of Western populations weekly, with 6% experiencing clinically significant symptoms. It equally impacts genders but increases in esophagitis cases amongst males over 40, especially smokers. GERD symptoms include heartburn and regurgitation, with atypical symptoms like chest pain and cough also possible. The complications range from peptic strictures to esophageal adenocarcinomas.<br /><br />**Diagnosis and Management:**<br />Diagnostic methods include pH testing and endoscopy, particularly with alarm symptoms such as bleeding or weight loss. GERD management primarily involves Proton Pump Inhibitors (PPIs), with H2 blockers serving less effectively. Surgery remains an option for those unresponsive to medication or with significant erosive esophagitis.<br /><br />**Barrett's Esophagus:**<br />This condition involves the extension of intestinal metaplasia into the esophagus, present in approximately 5.6% of Americans. Risk factors include being Caucasian, male, over 50, with GERD history, obesity, or smoking habits. Barrett’s progression leading to esophageal adenocarcinoma varies by dysplasia grade, and surveillance is crucial.<br /><br />**Treatment Options:**<br />Endoscopic therapies such as Radiofrequency Ablation (RFA), Cryotherapy, Endoscopic Mucosal Resection (EMR), and Endoscopic Submucosal Dissection (ESD) are discussed, offering both treatment and disease stage assessment measures. Surveillance intervals and patient counseling highlight the importance of personalized management plans.<br /><br />The presentation emphasizes long-term considerations regarding GERD and Barrett's, including lifestyle adjustments, possible interventions, and monitoring strategies to optimize patient outcomes in managing these conditions.

Asset Subtitle

Sarel Myburgh, APRN, CNP, MS

Keywords

Gastroesophageal Reflux Disease

GERD

Barrett's Esophagus

ASGE Annual GI Course

Proton Pump Inhibitors

Endoscopic therapies

Esophageal adenocarcinoma

Radiofrequency Ablation

Endoscopic Mucosal Resection

Surveillance strategies