1. Normal

2. Treatment of GERD
Wilcotte C Rahming, M.D.
Oconee Medical Center

3. SYMPTOMS
• Heartburn
• Bleeding
• Pain while swallowing
• Difficulty swallowing
• Weight loss

4. COMPLICATIONS
• Barrett’s
• Erosion
• Obstruction from scarring
• Cancer

5. DIAGNOSIS
• Medication trial
• Endoscopy

6. Barrett’s Esophagus
• Affects the lining of the esophagus
• 3.3 million adults > 50
• Pre-cancerous
• 30-125 X >
• Incidence increase 6 fold

7. Barrett’s Esophagus
• 13% Caucasian men > 50
• 25% > 50 w/o Sx’s
• 44% adults have Sx’s monthly
• 18% weekly

8. Types
• IM with

12. SURVEILLANCE
• No dysplasia every 3 years
• LGD 6 - 12 months
• HGD every 3 months

13. TREATMENT
• Lifestyle change
• Medication
• Endoscopic
• Surgery

14. ENDOSCOPY
• RFA
• APC
• PDT
• CSA

15. GOALS
• Eliminate all IM
• Prevent progression NDBE/LGD to HGD
• HGD to cancer
• Complete eradication of BE
• Not to eliminate need for surveillance