GERD

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GERD
What is it?
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Inefficient Valve at the LES
Angle of His Intra-abdominal Esophagus Hiatal
Hernia Muscular Dysfunction
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(No Transcript)
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SYMPTOMS

• Heartburn
• Chest Pain
• Waterbrash
• Dysphagia

• Aspiration
• Asthma
• Dental Erosion
• Hoarseness

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Treatment Nonmedical
Change eating habits Avoid aggravating
foods Gravity measures Avoid Tobacco Weight
Reduction
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Treatment Medical

• Direct Antacids
• Indirect Antacids
• H2 Blockers
• Proton Pump Inhibitors
• Coating Agents
• Prokinetic Agents

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Treatment Surgical

• Restore Valve Action!

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When?

• Complicated GERD
• Stricture
• Ulcer
• Barretts
• Aspiration
• Medical Intractability
• Patient Preference

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Surgical Options

• Thoracic Vs. Abdominal Approach
• Gastropexy
• Intususseption
• Wrap
• laparoscopic Vs. open
• partial Vs. complete