GERD Chalk Talk

 GERD

Causes: weak lower esophageal sphincter tone, H pylori

HPI: Eating habits, types of foods and beverages, medications: anticholinergics, opioids, positional symptoms, body habitus, extra esophageal, esophageal, Red Flag symptoms (dyspepsia, GI bleed, IDA, wt. loss)

Diagnostics: Endoscopy w/ bx, manometry, barium swallow, pH impedence (avoid in pts w/ transphenoidal fractures, pituitary surgery, nasal fractures)

Txtmt: 

lifestyle modification: avoidance of foods and meals 2-3 hours before bed

Medications: PPI: 8wk PPI trial before eating, split PPI pantoprazole 40mg (20mg 20mg) or 40mg BID, lansoprazole 30mg, famotidine 40mg

Surgery: Laparoscopic fundoplication (LES tone), bariatric surgery

Specialists: gastroenterologist, pulmonologist, otolaryngologist

Adverse effects of PPI: