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GERD - Coggle Diagram
GERD
Risk Factors
BMI 26 (overweight) - increased intra-abdominal pressure.
35 pack-year smoking history - weakens esophageal sphincter
Uncontrolled hypertension and diabetes - associated with poor diet and delayed gastric emptying
Male, age >50
Pathophysiology
lower esophageal sphincter decreased tone allows acid reflux into esophagus
Repeated acid exposure leads to mucosal inflammation
Aggravated by factors that decrease tone or increas intra-abdominal pressure
Clinical Presentation
Burning retrosternal pain (heartburn)
radiates to chest and jaw - can mimic angina
No elevation of troponin or ischemic ECG changes
Plan
Lifestyle Changes
Weight reduction (BMI goal <25)
Smoking cessation
Avoid late meals, alcohol, caffeine, spicy foods
Elevate head of bed 6–8 inches
Avoid tight clothing
Medications
Antacids
H2 blockers or PPIs
PPI trial to confirm diagnosis
POCT
CXR and EKG to rule out cardiac causes