1. The most common mechanism by which gastric contents reflux back into the esophagus
  2. What is the duration of a TLESR
    <1 min inhibition of the tone of the lower esophageal sphinctter
  3. typical symptoms of GERD
    • heartburn
    • bland or sour regurgitation
    • chest pain
    • dysphagia
    • odynophagia
    • Eructation
  4. does eradication of H.Pylori in patients with GERD induce reflux symptoms
    No and it does not seem to increase the need dose to treat symptoms.
  5. Risk factors for GERD
    • obesity
    • Hiatal hernia
    • Smoking
    • NSAID use
    • aging
    • IBS
    • anxioty
    • family history of GERD
  6. Extraesophageal manifestations of GERD
    • Asthma
    • Aspiration
    • laryngitis
    • laryngeal cancer
    • chrnoic cough
    • Sinusitis
    • Otitis media
  7. Symptoms of EOE
    • solid food dysphagia
    • recurrent vomiting (peds patients)
    • heartburn and chest pain
  8. lifestyle modifications for GERD
    • avoid large meals
    • avoid late evening meals
    • avoid foods that trigger symptoms
    • elevate head of bed if nocternal symptoms
    • avoid NSAIDS
    • lose weight
    • quit smoking
  9. Image Upload 1
    • squamous papilloma.
    • associated with mucosal injury and HPV infection
  10. risk factors for post infectious IBS
    • female
    • duration of illness
    • bloody stool
    • increased stress at time of incident
  11. Treatment of h. pylori infection in patients with functional dyspepsia will lead to improvement in symptoms how often
    1 in 14
  12. Historical features that predict gastroparesis
    • female gender
    • post prandial fullness as a prominent symptom.
  13. Men vs. Women with NASH,
    who has a higher rate of HCC
  14. major catagories of esophageal motility abnormalities
    • inadequate LES relaxation
    • uncoordinated contraction
    • hyperconraction
    • hypocontraction
  15. manometric features of classic achalasia
    • incomplete relaxation of the LES
    • aperistalsis in the body of the esophagus (amplitudes <40 mm HG
  16. Success rate for Pneumatic dilation of esophagus in achalasia
    • good results in 60-85% short term studies
    • 50% of patients treated will require follow up dilation within 5 years
  17. perforation rae with pneumatic dilation
    • 2-6%
    • 0.2% mortality
  18. incidence of reflux esophagitis in patients after pneumatic dilation
  19. Type II achalasia
    • simultaneous low amplitude pressurization in the entire esophagus
    • (this sub group responds best to all therapies)
  20. Diffuse esophageal spasm
    • greator that 10% of swallows with simultaneous contractions
    • amplitude >30mm Hg
  21. Nutcracker esophagus
    distal esophageal peristaltic wave amplitude >180mm Hg
  22. Ineffective esophageal motility
    30% of wet swallows

    • distal esophageal peristaltic wave amplitude <30mm HG
    • Failed peristalsis in which the wave does not propigate
    • absent peristalsis
  23. Normal Basal LES pressure
    10-45mm Hg
  24. LES relaxation with swallowing
    <8mm Hg
  25. duration of TLESR
    10-45 seconds
  26. percentage of patients that have typical GERD symptoms and normal endoscopy
  27. The only probiotic that has shown improvement in IBS
    bifidobacterium infantus
  28. Common allergies with EOE
    milk, soy, eggs, grains (especially barley), peanuts, seafood/shellfish and fruit (melons, apples).
  29. cancer in Barrett's esophagus that involves only the muscularis mucosa, but not the submucosa. What stage
  30. stage of esophageal cancer the invades into the muscularis mucosa but not into the muscularis propria
  31. Stage of esophageal cancer that extends to the submucosa
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