Recitation

• GERD is a digestive disorder that affects the ring of muscle between the esophagus and the stomach, known as the lower esophageal sphincter (LES)
• Symptoms of GERD include heartburn or acid indigestion
• Hiatal hernia may be a contributing factor to GERD
• More than 60 million American adults experience heartburn at least once a month, with over 15 million experiencing it daily
• Risk factors for GERD include being overweight or obese, pregnancy, delayed emptying of the stomach (gastroparesis), and diseases of connective tissue such as rheumatoid arthritis, scleroderma, or lupus
• Factors that can worsen acid reflux include smoking, certain foods and drinks (chocolate, fatty or fried foods, coffee, alcohol), large meals, eating too soon before bed, and certain medications like aspirin
• Common symptoms of GERD include heartburn, nausea, bad breath, trouble breathing, difficulty swallowing, vomiting, tooth enamel erosion, and a lump in the throat
• Treatment for GERD may involve lifestyle changes, over-the-counter or prescription medications such as antacids, H2 blockers, proton pump inhibitors (PPIs), and prokinetics
• Diet and lifestyle changes recommended for managing GERD include avoiding trigger foods and beverages, eating smaller portions, eating slowly, chewing food thoroughly, quitting smoking, elevating the head while sleeping, maintaining a healthy weight, wearing loose clothes, and considering acupuncture
• Severe GERD may require diagnostic tests such as endoscopy, upper GI series, esophageal manometry and impedance study, and pH testing
• Surgery for severe GERD may be necessary if other treatments are ineffective, including fundoplication, transoral incisionless fundoplication (TIF), Stretta procedure, and LINX surgery
• Complications of GERD can include esophageal ulcer, esophageal stricture, Barrett's esophagus, lung problems, and potential esophageal cancer
• Dumping syndrome can develop after certain surgeries or procedures, causing symptoms like abdominal cramps and diarrhea, and can be managed through dietary changes, medications, or surgery
• Dumping syndrome signs and symptoms:

  • Feeling bloated or too full after eating
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Flushing
  • Dizziness, lightheadedness
  • Rapid heart rate
• Late dumping syndrome signs and symptoms:

  • Sweating
  • Flushing
  • Dizziness, lightheadedness
  • Weakness
  • Rapid heart rate
• Contact your doctor if:

  • You develop signs and symptoms that might be due to dumping syndrome
  • Your symptoms are not controlled by dietary changes
  • You are losing large amounts of weight due to dumping syndrome
• Causes of dumping syndrome:

  • Food and gastric juices move from the stomach to the small intestine in an uncontrolled, abnormally fast manner
  • Most often related to changes in the stomach associated with surgery
• Risk factors for dumping syndrome:

  • Surgery that alters the stomach
  • Surgeries commonly performed to treat obesity, stomach cancer, esophageal cancer, and other conditions
• Diagnosis methods for dumping syndrome:

  • Medical history and evaluation
  • Blood sugar test
  • Gastric emptying test
• Treatment options for dumping syndrome:

  • Early dumping syndrome likely resolves on its own within three months
  • Diet changes may ease symptoms
  • Medications like octreotide can be prescribed for severe symptoms
  • Surgical procedures may be used if conservative approaches fail
• Lifestyle and home remedies for dumping syndrome:

  • Eat smaller meals
  • Drink most fluids between meals
  • Change your diet to include more protein and complex carbohydrates while limiting high-sugar foods
  • Increase fiber intake
• Zollinger-Ellison syndrome symptoms:

  • Abdominal pain
  • Diarrhea
  • Burning, aching, gnawing or discomfort in the upper abdomen
  • Acid reflux and heartburn
  • Burping
  • Nausea and vomiting
  • Bleeding in the digestive tract
  • Unintended weight loss
  • Decreased appetite
• When to see a doctor for Zollinger-Ellison syndrome:

  • Persistent upper abdominal pain with associated symptoms
  • Long-term use of over-the-counter acid-reducing medications
• Causes of Zollinger-Ellison syndrome:

  • Tumors (gastrinomas) form in the pancreas or duodenum, secreting large amounts of gastrin hormone
  • Excess gastrin leads to increased stomach acid production, causing ulcers and diarrhea
• Risk factors for Zollinger-Ellison syndrome:

  • Blood relatives with MEN 1
  • MEN 1 is an inherited condition associated with Zollinger-Ellison syndrome
• Diagnosis methods for Zollinger-Ellison syndrome:

  • Medical history
  • Blood tests to measure gastrin levels
  • Upper gastrointestinal endoscopy
  • Endoscopic ultrasound
  • Imaging tests like somatostatin receptor scintigraphy
• Treatment for Zollinger-Ellison syndrome:

  • Surgical removal of tumors
  • Proton pump inhibitors to control excess acid production
  • Other treatments to control tumor growth
  • Liver transplant in some cases
• Side effects of long-term use of proton pump inhibitors:

  • Increased risk of fractures of the hip, wrist, and spine
  • Risk should be weighed against the benefits of acid reduction
• Medication alternative for Zollinger-Ellison syndrome:

  • Octreotide (Sandostatin) can counteract the effects of gastrin and be helpful for some individuals