Page 246 - 2021 IDMT Digital

GASTROESOPHAGEAL REFLUX DISEASE (GERD)
Introduction:
• *DVWURHVRSKDJHDO UHIOX[ GLVHDVH RU ³KHDUWEXUQ´
• 'HYHORSV ZKHQ UHIOX[ RI VWRPDFK FRQWHQWV FDXVHV WURXEOHVRPH V\PSWRPV DQG
FRPSOLFDWLRQV
• $IIHFWV RI DGXOWV
• 0RVW SDWLHQWV KDYH PLOG GLVHDVH EXW VRPH FDQ KDYH HVRSKDJHDO PXFRVDO GDPDJH
• (WLRORJLHV
o 5HOD[DWLRQ RI ORZHU HVRSKDJHDO VSKLQFWHU /(6
o +LDWDO KHUQLD
o 7UXQFDO REHVLW\
Subjective:
• 6LJQV DQG 6\PSWRPV
o +HDUWEXUQ PLQXWHV DIWHU PHDOV
o 0D\ EH H[DFHUEDWHG E\ EHQGLQJ RU O\LQJ IODW
o 3RVVLEOH UHJXUJLWDWLRQ
o 0D\ SUHVHQW ZLWK FRXJK KRDUVHQHVV
• )RFXVHG +LVWRU\
o 7LPLQJ RI V\PSWRPV W\SHV RI IRRG
• ³5HG )ODJ´ 6\PSWRPV
o '\VSKDJLD RG\QRSKDJLD ZHLJKW ORVV LURQ GHILFLHQF\ DQHPLD
Objective:
• 3K\VLFDO ([DP
o $EGRPLQDO H[DP OLNHO\ WR EH QRUPDO LQ XQFRPSOLFDWHG GLVHDVH
• 7RROV
o 3RVVLEOH HQGRVFRS\ E\ *, LI VHYHUH RU LI V\PSWRPV DUH XQFRQWUROOHG RQ
PHGLFDWLRQ
Assessment:
• 'LIIHUHQWLDO
o 38' EUHDN LQ JDVWULF RU GXRGHQDO PXFRVD HSLJDVWULF SDLQ LV KDOOPDUN
HQGRVFRS\ UHTXLUHG IRU GLDJQRVLV
o '\VSHSVLD SDLQ DQG disFRPIRUW FHQWHUHG LQ WKH XSSHU DEGRPHQ GRHV QRW LQYROYH
UHIOX[ V\PSWRPV
o *DVWULWLV LQIODPPDWLRQ RI WKH JDVWULF PXFRVD
o $FXWH SDQFUHDWLWLV DEUXSW RQVHW RI GHHS HSLJDVWULF SDLQ RIWHQ ZLWK UDGLDWLRQ WR WKH
EDFN ODEV ZLOO VKRZ HOHYDWHG SDQFUHDWLF HQ]\PHV
o 3HUIRUDWHG SHSWLF XOFHU VXGGHQ LQWHQVH SDLQ RYHU HSLJDVWULXP

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