Gastroesophageal Reflux Disease (GERD) Quiz

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

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.