Upper GI Disorders: GERD and Peptic Ulcers

 Summarize the Upper GI Disorders: GERD and Peptic ulcers in terms of etiology, pathogenesis, clinical picture, diagnosis, and treatment rationale.

The 5 General Topics of Disease Summary
1. Etiology & risk factors
2. Pathogenesis: The molecular mechanism of the disease process (How the disease process evolves)
3. Clinical Picture: Signs& Symptoms, Sequelae, and Complications
4. Diagnosis: Labs & tests (as well as screening tests and follow-up tests whenever applicable)
5. Pathophysiologic rationale of treatment


This summary should cover two topics: 1- GERD.            2- Peptic Ulcer



Etiology: Weak lower esophageal sphincter. Discuss the factors that further weaken the sphincter and increase the possibility of acid regurgitation

Clinical picture: Symptoms and their rationale (wherever the acid goes certain symptoms happen: acid in the esophagus causes heartburn, at the back of the tongue, causes metallic bitter taste, pharynx, causes sore throat, larynx, causes hoarseness, carina, causes irritating cough, bronchi, causes bronchospasm)

Diagnosis: Characteristic clinical picture and 24-hour esophageal pH monitoring

The pathophysiologic rationale of treatment: PPI: Agents to reduce gastric acidity to minimize symptoms


Peptic Ulcer Disease

Etiology: H.pylori and NSAIDs are the two main causes, and also talk about ZE syndrome

Clinical picture: Symptoms of the two types of PUD (duodenal and gastric ulcers) are very similar

Diagnosis: Upper endoscopy confirms the diagnosis and tells apart the type

The pathophysiologic rationale of treatment: Deal with the cause (Avoid NSAIDs, antibiotics for H.Pylori), and reduce gastric acidity to ensure a suitable environment for the ulcer to heal

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