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GERD/PUD (Monitoring/Follow up (PUD: eradication of bacteria, if symptoms…

- - - - Famotidine
      - Ranitidine
      - Cimetidine
    - - Esomeprazole
      - Omeprazole
      - Lansoprazole
      - Pantoprazole
  - - - want to avoid long-term use (anti-cholinergic effects)
- - - - Hiatal hernia
      - Esophageal clearance
      - Ability of mucous to resist acid contact
      - Delayed Gastric emptying
      - Decrease in Lower esophageal sphincter pressure
      - eating close to bedtime
    - - esophagitis
      - esophageal strictures
      - barretts esophagus
      - esophageal adenocarcinoma
  - - - NSAID use
      - Smoking
      - Stress
      - H. pylori infection
      - Dietary factors
    - - Protective and Agressive factor balance
      - Stomach bleeding due to corrosion of stomach lining
      - Acid has broken down lining of stomach causing hole or tear
- - - - PPI
      - either amoxicillin or metronidazole
      - clarithromycin
    - - depends on resistance patterns
      - in pts with PCN allergy OR with previous exposure to macrolides