Simmons GERD_Handout.ppt

GERD, Dyspepsia, H pylori, Gastritis, PUD, Gastric Polyps Cancer James W. Simmons M.D. Overview GERD Definition Sx’s Diagnosis Pathogenesis and Treatment Atypical Manifestations Further Testing/Complications Erosive Esophagitis, Barrett’s Esophagus Overview Dyspepsia Definition Potential Causes Treatment Overview Helicobacter pylori Treatment Association with other conditions Overview Gastritis/Gastropathy Definition Classification Treatment Risk of Cancer Overview Peptic Ulcer Disease Treatment Strategy H pylori testing Biopsy High risk ulcers Overview Gastric Polyps Types Etiology Malignant potential Association with colon polyps Management Surveillance Overview Gastric Cancer Statistics Physical signs Diagnosis Biopsy Staging Histologic types Overview Gastric Cancer Less common cancers Risk factors Screening? GERD: Definition and Sx’s “Chronic symptoms or mucosal damage by the abnormal reflux of gastric contents into the esophagus.”* Heartburn is the most common symptom *Dent et al. Gut. 1999;44(suppl 2):S1-16. GERD: Definition and Sx’s The description “a burning feeling rising from the stomach or lower chest” has been found to be a more reliable indicator of patient’s symptoms than “heartburn” (40% vs. 13%) Carlsson et al. Scand J Gastroenterol. 1998;10:1023-1029. Symptoms of GERD Esophageal Heartburn Dysphagia Odynophagia Regurgitation Belching Extraesophageal Cough Wheezing Hoarseness Sore throat Globus sensation Epigastric pain Non-cardiac chest pain(NCCP) Factors That Can Aggravate GERD Diet – Caffeine, fatty/spicy foods, chocolate, coffee, peppermint, citrus, alcohol Position/Activity – Bending, straining External Pressure – pregnancy, tight clothing GERD Prevalence ~10% of the US population experience heartburn daily* ~40% experience heartburn monthly* Prevalence increases in industrialized nations (Yes, USA is #1!) Many self-diagnose and treat *Kahrilas et al. In: Sleisenger Fordtran’s Gastrointestinal and Liver Disease. 7th ed. 2002:5