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3ий курс / English / Class 2. GERD, gastritis, peptic ulcer.pptx
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GERD, Gastritis, Peptic

ulcer

Gastro-esophageal reflux disease

Heartburn

(100%)

Epigastric pain

High risk of complications and low vital quality due to reflux

Benign origin of pathological signs

Regurgitation

Without

esophagitis

Belching

Nausea

With esophagitis

 

Meteorism

Abdominal pain

Symptoms of GERD are not associated with presence of esophagitis

Heartburn and reflux: what is it?

“Burning feeling spreading from

 

the stomach/lower part of chest to

Reasons of gastro-esophageal

the neck”

reflux

Dysfunction of esophageal sphincter

Heartburn– most common symptom of

GERD (75%) Slow evacuation

Damage of esophageal clearance

Hernia

Increased intraabdominal pressure

Possible extraesophageal manifestations of GERD

Bronchial astma

Sinusitis

Caries

Laryngitis

Ulceration of vocal cords

Tracheal stenosis

Laryngospasm

Esophageal manometry

24-hour monitoring of pH for reflux detection

Degree and duration of reflux

Compare with symptoms

Targets for GERB treatment

Relief of symptoms (heartburn)

Treatment of esophagitis

Treatment and prevention of complications

Control of acidity – most effective way

• Inhibitors of proton pomp – first line treatment

PPI doses for severe oesophagitis in this guideline update (2014)

Esomeprazole

40 mg1 once a day

20 mg1 once a day

40 mg1 twice a day

Lansoprazole

30 mg once a day

15 mg once a day

30 mg2

twice a day

Omeprazole

40 mg1 once a day)

20 mg1 once a day)

40 mg1

twice a day

Pantoprazole

40 mg once a day

20 mg once a day

40 mg2

twice a day

Rabeprazole

20 mg once a day

10 mg once a day

20 mg2

twice a day

1

Change from the 2004 dose, specifically for severe oesophagitis, agreed by the GDG during the update of CG17.

2

Off-label dose for GORD.

 

 

 

 

Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management Clinical guideline [CG184]. NICE guidance

Balance of aggressive and protective factors in stomac

Norm

Peptic ulcer

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