GASTROENTEROLOGY ARTICLE OF THE WEEK

April 13, 2000

 1.  Upper endoscopic evaluation for patients with GERD is recommended in which of the following circumstances

            a.  patients with a complete response to medical therapy

            b.  patients with no or incomplete response to medical therapy

            c.  patients with dysphagia and weight loss

            d.  significant symptomatic reflux for 15 years in a white individual 

2.  Chronic PPI therapy for reflux

            a.  has no effect on the frequency of dilations for patients with peptic strictures

            b.  likely has no effect on progression or regression of Barrett’s esophagus

            c.  prevents squamous cell carcinoma of the esophagus

            d.  may improve esophageal motility in some patients with reflux 

True or False

 3.  Pro-motility agents are less efficacious than H2 RA’s

 4.  Prior to anti-reflux surgical procedure, all patients should undergo esophageal manometry, 24-hr pH monitoring and gastric emptying studies 

5.  Only patients with severe, frequent heartburn over many years are at risk for Barrett’s esophagus 

6.  Normal appearing esophageal mucosal should always be biopsied when reflux is suspected. 

7.  A normal pH monitor test score in a patient on no acid suppression excludes the diagnosis of GERD 

8.  The use of omeprazole with dose titration up to 60mg per day yields similar 3-yr symptom relief results than antireflux surgery 

9.  Dental erosions due to GERD rarely occur unless the patient has symptoms of severe GERD.

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