gerd guidilines.pptx
TRANSCRIPT
Guidelines for the Diagnosis and Management of Gastroesophageal
Reflux Disease
Supervised by :Dr. Riki Tenggara, Sp.PD-KGEH,M.Kes
Presented by :Athalia Talaway 2013-061-0
Kezia Jessica 2014-061-038
Introduction
• GERD : symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, into the oral cavity (including larynx) or lung.
• Classified as : – Non- erosive disease / NERD– Erosive disease / ERD
• Prevalence of GERD : 10–20% of the Western world with a lower prevalence in Asia.
• Clinically troublesome heartburn is seen in about 6% of the population
• Regurgitation was reported in 16% of the population
Epidemiology & Symptoms
• Chest pain • Dysphagia • Extraesophageal symptoms : chronic cough,
asthma, chronic laryngitis• Atypical symptoms : dyspepsia, epigastric
pain, nausea, bloating, belching
Epidemiology & Symptoms
3.4.
Diagnosis Recommendation
Barium Radiograph
Endoscopy
Alarm SymptomsScreening high risk complication
7.
8.
9.
Diagnosis RecommendationRoutine Biopsies distal esophagus
Esophageal Reflux Monitoring
Endoscopic/surgical therapy NERDEvaluation refractory PPI
Diagnosis GERD
1.
2.
Management Recommendation
Weight loss
Head of bed elevationAvoidance meal 2-3 h before
bed time
3.
4.
Management Recommendation
8 weeks PPI30-60 minutes
before meal (1x)
Twice daily dosing: night-time symptoms,
variable schedules, sleep disturbance.
5.
6.
Management Recommendation
Maintenance PPI have symptoms after PPI is discontinued
erosive esophagitis Barrett’s esophagus.
Long term PPI lowest effective dose, including on demand/ intermittent therapy
7.
Management Recommendation
maintenance option in patients without erosive
disease H-2 Receptor Antagonist
Pro kinetic , Baclofen Diagnostic Evaluation