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GERD (Path: Acid w/ weakened LES : leads to esophagitis (Pt: Typical- …

- - - - :pencil2:Avoid
        
        chocolate :chocolate_bar:
        
        peppermint :candy:
        
        smoking :no_smoking:
        
        EtOH :beer_mugs:
        
        Also dont have a huge meal before sleep, dont lie down immediately after eating
      - f/u: EGD w/ biopsy
        
        :pencil2:will only show esophagitis w/ eosinophils
        
        24 hr pH monitor
        
        :pencil2:pH lines up w/ pt logbook of sx
        
        surgery?
        
        get manometry, but only if sx, to be sure
        
        :warning:~~manometry~~ is a bad test answer
        
        Metaplasia (Barretts) w/ GERD :checkered_flag:
        
        increase dose PPI
        
        Dysplasia :checkered_flag:
        
        Tx: Local ablative therapy
        
        :pencil2:Prevents cancer: staging & resection
        
        :warning:f/u surveillance EGD
        
        :checkered_flag:Adenocarcinoma
        
        Staging, CTX, resection
      - improves? :checkered_flag: GERD
        
        Tx: PPI
      - :green_cross:Can't tolerate PPi
        
        Nissen Funoplication: Wrapping up the LES tight