Transcription for CPG GERD Hello Dr. and Class, my name is and I will be presenting clinical practice guidelines for Gastroesophageal reflux disease (GERD) Slide #1 Clinical Practice Guidelines. Gastroesophageal reflux disease or GERD Gastroesophageal reflux disease (GERD) is one of the most common diseases encountered by the gastroenterologist and is equally as common in the primary care setting. This presentation will provide a summary of GERD and its clinical presentation, and recommendations to diagnosis and how to manage the disease. Slide #2 Disease definition GERD defined as symptoms or complications resulting from the reflux of gastric contents into the esophagus or beyond, into the oral cavity (including larynx) or lung (DeVesty, & Heering, 2018). Slide # 3 Prevalence of GERD is based primarily on the typical symptoms of heartburn and regurgitation. Estimated that 10%-20% of adults have GERD, over 8.9 million primary care visits annually. But prevalence of GERD is unknown. It occurs most often in adults older than 40 yo. Same incidence between men and women. Except experienced more in women during pregnancy. Clinically troublesome heartburn is seen in about 6% of the population (Katz, Gerson, & Vela, 2013) Slide #4 Pathophysiology GERD is caused by the anatomical malfunction of the lower esophageal sphincter (LES) which is located at the bottom of the esophagus. LES is a muscle that is located at the end of the esophagus which is responsible for peristalsis and closes to prevent acidic stomach content from moving back to the esophagus. Esophageal reflux occurs when the gastric volume increases such as a large meal or the intra-abdominal pressure increases as such during pregnancy. It can also occur when the sphincter tone of the Lower Esophageal Sphincter is decreased by the use of caffeine or when the Lower Esophageal Sphincter undergoes inappropriate relaxation. As the esophagus becomes inflamed with repeated exposure to gastric acid, it cannot eliminate the refluxed material as quickly or efficiently, prolonging the duration of the contact with each subsequent exposure (May, Rao, Dipiro, Talbert, Yee, Matzke, Wells, Posey, 2014). Slide #5 Clinical Presentation Include heartburn, regurgitation, odynophagia, dysphasia, substernal or retrosternal chest pain, globus sensation, obesity, dental erosions, hoarseness, belching, and coughing