Gastroesophageal Reflux Disease (GERD) Quiz

Study Notes

Gastroesophageal Reflux Disease (GERD)

A common disorder characterized by backflow of gastric or duodenal contents into the esophagus, causing symptoms and/or mucosal injury to the esophagus.

Causes of GERD

Incompetent lower esophageal sphincter
Pyloric stenosis
Hiatal hernia
Motility disorder
Tobacco use
Coffee drinking
Alcohol consumption
Gastric infection with Helicobacter pylori
Can occur in patients with irritable bowel syndrome, obstructive airway disorder exacerbations, peptic ulcer disease, and angina
Increases with aging

Clinical Manifestations

Pyrosis (heartburn, a burning sensation in the esophagus)
Regurgitation
Dyspepsia (indigestion)
Dysphagia or odynophagia
Hypersalivation
Esophagitis
Can result in dental erosion, ulcerations in the pharynx and esophagus, laryngeal damage, esophageal strictures, adenocarcinoma, and pulmonary complications

Assessment and Diagnostic Findings

History
Ambulatory pH monitoring (gold standard for diagnosis)
Endoscopy or barium swallow to evaluate damage to the esophageal mucosa and rule out strictures and hernias
Ambulatory pH monitoring involves transnasal catheter placement or endoscopic wireless capsule placement for approximately 24 hours

Management

Educating patients to avoid situations that decrease lower esophageal sphincter pressure or cause esophageal irritation
Lifestyle modifications:
- Tobacco cessation
- Limiting alcohol
- Weight loss
- Elevating the head of the bed
- Avoiding eating before bed
- Altering the diet
Medical management:
- Antacids/Acid Neutralizing agents (e.g. calcium carbonate, aluminum hydroxide, magnesium hydroxide and simethicome, alginate)
- Histamine-2 (H2) receptor antagonists (e.g. famotidine, cimetidine)
- Prokinetic agents (metoclopramide)
- Proton pump inhibitors (PPIs) (First-line drugs used)
- Reflux inhibitors (Bethanechol chloride)
- Surface agents/Alginate-based barriers (Sucralfate)
- Inhibitors of transient lower esophageal sphincter relaxations (TLESRs) (Baclofen)
Surgical management:
- Open or laparoscopic Nissen fundoplication (wrapping of a portion of the gastric fundus around the sphincter area of the esophagus) if medical management is unsuccessful

Description

This quiz covers the causes, symptoms, and effects of Gastroesophageal Reflux Disease, a common disorder that occurs when stomach acid flows back into the esophagus. Test your knowledge of GERD and its relationships with other health conditions.