ASGE Masterclass: Barrett’s Esophagus, GERD and Esophageal Adenocarcinoma (On Demand)

Video Transcription

Video Summary

The video discusses the evaluation and interpretation of tests for patients with ongoing reflux symptoms. It mentions the potential diagnoses of hypersensitive esophagus or functional heartburn in patients with negative pH tests but symptoms correlated with reflux. Treatment options for these patients include antidepressant therapy, pain modulators, and proton pump inhibitors (PPIs). The speaker suggests trying these approaches before considering fundoplication surgery, as many patients are hesitant due to potential side effects. The video also addresses the interpretation of a borderline Demeester score, stating that a total acid exposure time of more than 6% indicates reflux. The preferred neuromodulators for a hypersensitive esophagus are Elavil and Trazodone, starting at low doses and monitoring for potential side effects. The video emphasizes the importance of considering multiple factors in test interpretation. The speaker cautions about the potential for urinary retention with Elavil in older patients and those with prostate hypertrophy.

Keywords

reflux symptoms

hypersensitive esophagus

functional heartburn

treatment options

test interpretation