Rotations 2.0 Episode 33 Peptic Ulcer Disease

Episode 33 Peptic Ulcer Disease

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Best Dramatic Music by Onoychenko

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 32 GERD

Question 1: Diagnostic Strategy

A 45-year-old male presents with persistent heartburn and regurgitation despite an 8-week trial of single-dose PPI therapy. He denies dysphagia, weight loss, or gastrointestinal bleeding. Endoscopy reveals no erosive esophagitis or Barrett’s esophagus. What is the most appropriate next step in management?
C. Perform prolonged wireless pH monitoring off PPI therapy

Question 2: Pharmacologic Management

Which of the following adjunctive therapies is most appropriate for a patient with GERD who experiences breakthrough symptoms despite optimized PPI therapy?

A. Alginate antacids

Question 3: Surgical Considerations

A 52-year-old obese female with confirmed GERD and a large hiatal hernia is considering surgical intervention. Which of the following procedures is most appropriate as a primary anti-reflux intervention?

C. Roux-en-Y gastric bypass

Paper for next week:

Kai-Yue Huang, Feng-Yun Wang, Mi Lv, Xiang-Xue Ma, Xu-Dong Tang, Lin Lv, Irritable bowel syndrome: Epidemiology, overlap disorders pathophysiology and treatment, World J Gastroenterol 2023 July 14; 29(26): 4120-4135

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