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Diagnosis and Management of Gastroesophageal Reflux Disease (GERD)

Definition
Presentation
Medical Management
Extraesophageal Symptoms
Long-Term PPI Issues
Diagnosis Algorithm
Refractory GERD
Surgical and Endoscopic
of Gastroesophageal ... Reflux Disease ... Extraesophageal Symptoms ... #Gastroesophageal ... #Reflux #Disease
Gastroesophageal Reflux Disease (GERD) Summary
 - Diagnosis
 - Clinical Workflow
 - PPIs
 - Treatment
 - Acid
Gastroesophageal ... Reflux Disease ... (GERD) Summary ... #Reflux #Disease ... #diagnosis #management
Gastroesophageal Reflux Disease (GERD) - Summary

GERD: Diagnosis
• Heartburn (substernal burning sensation) and acid regurgitation
• Chest pain
Extraesophageal
Gastroesophageal ... Reflux Disease ... reduction • Avoid “trigger ... #Gastroesophageal ... #diagnosis #management
GERD and Recommended Lifestyle Modifications
 • Avoid fatty meals
 • Avoid carbonated beverages
 • Avoid citrus,
GERD and Recommended ... citrus, if it triggers ... symptoms • Eat ... #reflux #acid # ... Modifications #management
Leukostasis vs Tumor Lysis Syndrome
Leukostasis:
 • Pathophysiology: Large, immature blasts and high WBC count cause hyperviscosity
Leukostasis: • Pathophysiology ... hyperviscosity syndrome • Triggers ... Lysis Syndrome: • Pathophysiology ... into serum • Triggers ... TLS #diagnosis #management
Ear Pain (Otalgia) - Differential Diagnosis Framework

Primary Otalgia 
 - Pain that originates from the ear
the following symptoms ... reflux • Head ... reflux disease ... (GERD), esophageal ... • Associated symptoms
Efficacy of lifestyle interventions for GERD
Weight loss:
 - Improvement of GERD symptoms and esophageal pH
 -
symptoms and esophageal ... esophageal pH and symptoms ... acidity but not symptoms ... symptoms Cessation ... #reflux #management
Esophageal Necrosis
Etiology:
 - Ischemia and Gastric Outlet Obstruction with GERD may be inciting events
 - Associated
Obstruction with GERD ... injury (by acid reflux ... promote esophageal reflux ... melena - Other GI symptoms ... Necrosis #diagnosis #management
Differentiation Syndrome in APML
Epidemiology:
 • Incidence: common in APL (2-48% depending on the study)
 • Triggers:
the study) • Triggers ... ATRA treatment Pathophysiology ... Diagnosis: >3 symptoms ... APML #diagnosis #management
Most episodes of chronic cough in adults are caused by upper airway cough syndrome (UACS, also
syndrome), asthma, or gastroesophageal ... reflux disease ... (GERD), alone or ... chronic cough until symptoms