Heartburn and dyspepsia (General Surgery EOR - Smarty PANCE) Exam Questions and Answers Graded A+

Heartburn and dyspepsia (General Surgery EOR - Smarty PANCE) Exam Questions and Answers Graded A+ What is GERD? Excessive reflux of gastric contents into the esophagus, "heartburn" What are the causes of GERD? -Decreased lower esophageal sphincter (LES) tone (50% of cases) -Decreased esophageal motility to clear refluxed fluid -Gastric outlet obstruction -Hiatal hernia in 50% of patients What are the signs/symptoms of GERD ? Heartburn, regurgitation, respiratory problems/pneumonia from aspiration of refluxed gastric contents; substernal pain What disease must be ruled out when the symptoms of GERD are present? Coronary artery disease What tests are included in the workup? EGD, UGI contrast study with esophagogram, 24-hour acid analysis (pH probe in esophagus). Manometry, EKG, CXR What is the medical treatment of GERD? Small meals, PPIs (proton-pump inhibitors) or H2 blockers, Elevation of head at night and no meals prior to sleeping What are the indications for surgery for GERD?