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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
Gastroesophageal Reflux ... Algorithm Refractory ... and Endoscopic Therapy ... #Management #Treatment ... #Algorithm #Gastroenterology
Gastroesophageal Reflux Disease (GERD) - Summary

GERD: Diagnosis
• Heartburn (substernal burning sensation) and acid regurgitation
• Chest pain
Extraesophageal
Gastroesophageal Reflux ... : Diagnosis • Heartburn ... Testing Ambulatory reflux ... #Disease #diagnosis ... #management #Gastroenterology
Upper GI Bleed - Management Algorithm

Upper GI bleed Suspected: Melena, hematemesis, coffee-ground emesis, BRBPR
Initial Stabilization
Concern for
Management Algorithm ... Consult GI ± EGD ... #GI #Bleed #UGIB ... #Differential #Diagnosis ... gastrointestinal #gastroenterology
Forrest Classification of Upper GI Bleeding
Acute Hemorrhage
  Ia - Active Spurting, Re-bleeding Risk 60-100%
Classification of Upper ... #GIBleed #UGIB ... #diagnosis #endoscopy ... #gastroenterology ... #egd
Esophageal Necrosis
Etiology:
 - Ischemia and Gastric Outlet Obstruction with GERD may be inciting events
 - Associated
Obstruction with GERD ... patients present with upper ... : - EGD showing ... : - Treatment of ... #management #gastroenterology
Endoscopy in Non-Variceal Upper GI Bleeding - Scoping Summary
Pre-Endoscopic Care:
 • Adequate resuscitation: Restrictive> Liberal strategy
Upper GI Bleeding ... GBS, high sens. >12 ... • Start with EGD ... #diagnosis #management ... #algorithm
Gastroenterology Endoscopy Tools and Accessories - A Visual Catalog for Trainees and Young Gastroenterologists
Biopsy Forceps:
Gastroenterology ... for palliative treatment ... laceration in upper ... ENTEROSCOPE - Diagnostic ... Aguila @enrrikke #Gastroenterology
Diagnosis and Management of Achalasia - ACG Guidelines

Who to suspect?
 • Patients presenting with progressive dysphagia
Diagnosis and Management ... with GERD who are ... • Endoscopy to look ... puckering of the EGJ ... ACG #Guidelines #gastroenterology
Achalasia Summary

Epidemiology: 10 cases per 100,000 individuals

Defined by inadequate relaxation of the LES and aperistalsis
Primary or
: Testing The diagnosis ... EGD: • Exclude ... GERD 2. ... #Achalasia #diagnosis ... #gastroenterology