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Introduction
Think about the foods you typically eat, how often do you consume citrus fruits,
caffeinated, carbonated, or alcoholic beverages, or CHOCOLATE?
With a gastroesophageal reflux disease (GERD), these foods should be eliminated
Heartburn
Chest pain
Increased salivation
Belching
Ipohecho.com.my
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Educational Video
https://www.bing.com/videos/search?q=gerd+video&&v
iew=detail&mid=915FCCFE4690483F45BC915FCCFE
4690483F45BC&&FORM=VRDGAR
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Medical Treatment
Medication: (5)
Proton Pump Inhibitors (PPI) inhibit acid secretions (Omeprazole)
H2 Blockers block the action of histamine on parietal cells, decreasing the production of
acid (Ranitidine)
Prokinetics increase the ability for the stomach to contract and shortens emptying time
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Research
Aim: to evaluate the clinical outcome of GERD in a population of overweight and obese patients suffering
from this disease in comparison with a control group with normal BMI.
Materials and Methods: 365 patients diagnosed with GERD were divided into two groups according to
BMI (26->30 = Group 1) and (20-25 = Group 2). These patients were followed up for 10 years with at
least one regular examination every two years with an upper GI endoscopy. GERD symptoms (heartburn,
regurgitation, chronic cough) were recorded by a question are at every visit.
Results: The percent of esophagitis with the obese BMI group was 52% of people and the percent of
esophagitis in the normal BMI group was only 36%. In all questioner questions the group associated with
the obese BMI claimed to have a higher severity.
Conclusion: Overweight and obesity are associated with a worse outcome of GERD in a long term
follow up according to endoscopies and severity of symptoms.
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Assessment
48 y/o Indian male recently diagnosed with gastroesophageal reflux disease and hypertension,
recent complaint of indigestion. Abnormal lab values include elevated triglycerides and
cholesterol. Current medications include omeprazole, aspirin, multi-vitamin, and ibuprofen as
needed. Family history of heart disease. Had knee surgery 3 years ago, weight gain of 30 #
since, due to physical inactivity and stress related eating and alcohol drinking problems.
Physical activity is limited to playing with children on the weekends. Lives with his wife and
children, wife does the cooking, if she doesn’t cook patient goes out to eat. Diet history revealed
energy dense foods with large amounts of sugar-sweetened beverages. Patient eats a
combination of traditional Indian foods with American foods, doesn't follow any strict dietary
practices related to his religious background of Hinduism. Patient complained that fried foods
seem to make indigestion worse.
Ht= 60”, Wt= 215#, BMI= 32, UBW= 185#, %UBW= 116%
RD counseled patient on choosing lower calorie and fat snack options, for
example having carrots and peppers instead of crackers as an after-work snack.
RD encouraged patient to limit fried foods by packing leftovers from home instead
of ordering out, consume smaller/more frequent meals, and eliminate
carbonated/caffeinated/alcoholic beverages by supplementing with water or low-
fat milk. Patient was willing to pack leftovers for lunch, replace diet Pepsi with
Propel, and limit caffeinated beverage intake after lunch.
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Monitoring and Evaluation
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References
Di Mario, F., Savarino, E., Miraglia, C., De Bortoli, N., Franceschi, M., Scida, S., ... & Bertelè, A. (2017). P. 01.14: Overweight
and Obesity as Risk Factors for Gerd Outcome: A 10 Years Study on a Gerd Population of 365 Patients. Digestive and
Liver Disease, 49, e137
Kaechele, J. (2018, January 16). Three facts everyone with GERD should know. Retrieved November 1, 2018, from
https://www.refluxmd.com/three-facts-everyone-gerd-know/
M. (2018, March 09). Gastroesophageal reflux disease (GERD). Retrieved November 1, 2018, from
https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959
Preidt, R. (2017, December 21). Chronic Heartburn Tied to Higher Odds for Head, Neck Cancers. Retrieved November 1, 2018,
from https://www.webmd.com/heartburn-gerd/news/20171221/chronic-heartburn-tied-to-higher-odds-for-head-neck-
cancers#1
Williams, W. (2012, December 13). Acid Reflux Aciphex Medical Animation. Retrieved November 1, 2018, from
https://www.bing.com/videos/search?q=gerd
video&&view=detail&mid=915FCCFE4690483F45BC915FCCFE4690483F45BC&FORM=VRDGAR