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Title:

Reflux

Description:

Title: Complex Reflux Disease Author: Yuen Soon Last modified by: Yuen Created Date: 4/5/2009 9:54:07 PM Document presentation format: On-screen Show (4:3) – PowerPoint PPT presentation

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Title: Reflux


1
Reflux
2
Common Symptoms
  • Heartburn
  • Globus
  • Chest Pains

3
Complex Reflux Symptoms
  • Mass Reflux
  • Cough/Asthma/recurrent Chest Infections
  • Sore Throat

4
Complex Symptoms
  • Dysphagia
  • Pain

5
Differential Diagnoses
  • Cancer
  • Dysmotility
  • Oesophageal
  • gastric

6
Treatment
  • Conservative
  • Medical
  • PPI
  • Barrier
  • Surgical

7
Medical vs Surgical
  • Only three Trials of Lap vs Medicine
  • Mahon 2005
  • Anvari 2006
  • Grant 2008
  • All Show improve QOL at 1 year

8
Indications for Surgery
  • Lifestyle
  • Breakthrough Symptom Control
  • Complex Reflux Control

9
Why pH Manometry
  • Prove reflux
  • Avoid dysmotility
  • Manage expectation

10
Patients
  • All three patients described have
  • Dysphagia
  • Odynophagia
  • Reflux

11
Hypotensive dysmotility typical of GORD
12
Hypotensive dysmotility typical of GORD
13
Vigorous Achalasia
14
Vigorous Achalasia
15
Vigorous Achalasia
16
Structural obstruction at the PIP
17
(No Transcript)
18
Complex Reflux Disease
  • Mr Yuen Soon
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