Jove
Visualize
Contact Us

Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

Gastroesophageal Reflux Disease I: Meaning and Pathophysiology

Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The history and use of the timed barium esophagram in achalasia, esophagogastric junction outflow obstruction, and esophageal strictures.

Neurogastroenterology and motility·2024
Same author

Esophageal Lichen Planus: The Efficacy and Safety of Tacrolimus in Reducing Inflammation and Need for Dilation.

Clinical and translational gastroenterology·2024
Same author

Impact of opioids on treatment response among idiopathic esophagogastric junction outflow obstruction patients: A retrospective cohort study.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology·2023
Same author

Inter- and intra-rater agreement of interpretation of functional lumen imaging probe in healthy subjects.

Neurogastroenterology and motility·2022
Same author

Correction to: Demystifying Esophageal Lichen Planus: A Comprehensive Review of a Rare Disease You Will See in Practice.

The American journal of gastroenterology·2022
Same author

Update on the Diagnosis and Treatment of Achalasia.

Dysphagia·2022
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Video

Updated: Jul 9, 2026

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver
08:25

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver

Published on: August 27, 2021

How to manage refractory GERD.

Joel E Richter1

  • 1Department of Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA. jrichter@temple.edu

Nature Clinical Practice. Gastroenterology & Hepatology
|November 29, 2007
PubMed
Summary

Patients with refractory GERD unresponsive to proton pump inhibitors (PPIs) require further investigation. Endoscopy is key, followed by specialized tests to diagnose causes like esophagitis or non-acid reflux.

Area of Science:

  • Gastroenterology
  • Gastrointestinal Disorders

Background:

  • Refractory gastroesophageal reflux disease (GERD) affects patients unresponsive to standard proton pump inhibitor (PPI) therapy.
  • Accurate diagnosis is crucial for effective management of refractory GERD.

Purpose of the Study:

  • To outline the diagnostic approach for patients with refractory GERD.
  • To identify potential causes of GERD symptoms despite adequate PPI treatment.

Main Methods:

  • Initial investigation includes upper endoscopy to rule out peptic ulcer disease, cancer, and identify esophagitis.
  • For normal endoscopy findings, further tests like 48-hour pH monitoring, impedance testing, esophageal manometry, and gastric function tests are considered.
  • Evaluation for less common causes like pill-induced esophagitis, autoimmune conditions, eosinophilic esophagitis, hypersecretory syndromes, or altered PPI metabolism.

More Related Videos

Technical Considerations and Approach to Redo Foregut Surgery
04:14

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Related Experiment Videos

Last Updated: Jul 9, 2026

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver
08:25

Construction of a Wireless-Enabled Endoscopically Implantable Sensor for pH Monitoring with Zero-Bias Schottky Diode-based Receiver

Published on: August 27, 2021

Technical Considerations and Approach to Redo Foregut Surgery
04:14

Technical Considerations and Approach to Redo Foregut Surgery

Published on: September 22, 2023

Main Results:

  • Esophagitis in refractory GERD suggests specific causes such as pill-induced injury, autoimmune disease, or eosinophilic esophagitis.
  • Normal endoscopy findings in refractory GERD necessitate advanced testing to uncover etiologies like nocturnal acid breakthrough, nonacid reflux, or functional heartburn.
  • Other differential diagnoses for refractory GERD with normal endoscopy include achalasia, gastroparesis, and functional heartburn.

Conclusions:

  • A systematic diagnostic strategy is essential for refractory GERD.
  • Endoscopy is the primary investigation, guiding further specialized testing based on findings.
  • Identifying the specific cause of refractory GERD is critical for targeted treatment and improved patient outcomes.