ASGE Annual GI Advanced Practice Provider Course (Virtual) - Day Two

Video Transcription

Video Summary

In the video, the speakers address various questions related to pregnant patients, testing for listeria, safe anti-reflux medications for pregnancy and breastfeeding, false low values in pink retic fecal elastase tests, discussions with patients about PPIs and potential side effects, differences between barium swallow and esophagram, the treatment of gas bloat symptoms after Nissen surgery, TIF procedure after a failed Nissen, and next steps in the workup of oropharyngeal dysphagia. They discuss the need for a cluster of symptoms to test for listeria in pregnant patients and the importance of ruling out other infections and discussing treatment options with OB-GYNs. They mention that FDA category B medications are generally safe for pregnancy and breastfeeding, and discuss the use of H2 blockers and carafate in failed Tums and Pepcid cases. The speakers emphasize the need for further testing when faced with a falsely low pink retic fecal elastase test. They also highlight the importance of open discussions with patients about the risks and benefits of PPIs and alternative treatment options. The speakers explain the differences between barium swallow and esophagram, with barium swallow providing static images and the movie x-ray of the bolus transit, and esophagram offering a different visual perspective for spotting certain conditions. They mention that nausea and vomiting can be associated with GERD but caution that further investigation may be necessary depending on the severity and associated symptoms. They also discuss the possibility of TIF procedure following a failed Nissen surgery, although they note the limited data and the importance of operator expertise. Regarding oropharyngeal dysphagia, they suggest checking for myasthenia gravis and considering neuropsychiatric testing in select cases. Lastly, they mention optimal osmotic gap cutoffs for diagnosing secretory diarrhea, suggesting a cutoff of around 75 rather than the gray zone of 50 to 100.

Keywords

pregnant patients

testing for listeria

safe anti-reflux medications

pink retic fecal elastase tests

discussions with patients