GI Disorders

GERD

Clinical Manifestations

• Heartburn
• Non-Cardiac Chest Pain
• Respiratory irritation
• Hypersalivation
• Sore throat, globus

GI Disorders

• Foods
• Smoking
• Alcohol
• NG intubation
• Obesity
• Hiatal Hernia

Complications of gerd

• Barrett's Esophagus
• Aspiration/Respiratory Issues
• Dental Erosion
• Esophagitis/Strictures

Diagnostics

Drug Management of GERD

• PPIs
• H2 Receptor Blockers
• Antacids
• Others...

PPIs - ranitidine, cimetidine, famotidine (decrease H+ ions)

H2 Blockers - omeprazole, pantoprazole, lansoprazole (decrease HCl secretion)

Other GERD MEds

• bethanecol - increases LES pressure
• metoclopramide - increases motility
• sucralfate - cytoprotective

gerd Management

• High protein, low fat diet
• Small, frequent meals
• HOB elevated
• Avoid milk products, snacks at night
• Avoid aggravating drugs
• Fluids between meals

GERD Management

Peptic Ulcers

Causes of peptic ulcers

• H. Pylori
• ASA and NSAIDs
• Alcohol, Smoking, Caffeine
• Stress

ulcer signs & Symptoms

• Anorexia
• Hematmesis/Melena
• Nausea/vomiting
• Epigastric pain 1-2 hrs after eating
• Pain relief after antacids