Patient with Gastrointestinal Disease - Understanding GERD and PUD
In this comprehensive presentation, Dr. Gza T. Terzhalmy discusses Gastroesophageal Reflux Disease (GERD) and Peptic Ulcer Disease (PUD). Explore the mechanisms of action of proton pump inhibitors, risk assessment factors, symptoms of GERD and PUD, treatment strategies, and more. Gain insights into the impact of H. pylori infection, COX-1 inhibitors, stress, smoking, alcohol, and caffeine on gastrointestinal health.
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Presentation Transcript
Gza T. Terzhalmy, D.D.S., M.A. Professor and Dean Emeritus School of Dental Medicine Case Western Reserve University Cleveland, Ohio gtt2@case.edu
The Patient With Gastrointestinal Disease GASTROESOPHAGIEAL REFLUX DISEASE (GERD) AND PEPTIC ULCER DISEASE (PUD) 2/13/2025 2
The Patient With Gastrointestinal Disease (GERD and PUD) Proton pump inhibitors in the top 200 - 2010 Aciphex (rabeprazole) Nexium (esomeprazole) omeprazole pantoprazole sodium Prevacid (lansoprazole) 2/13/2025 3
The Patient With Gastrointestinal Disease (GERD and PUD) Mechanisms of action Inhibit H+/K+ATPase 2/13/2025 4
Risk assessment Disease-related variables 2/13/2025 5
The Patient With Gastrointestinal Disease (GERD and PUD) GERD Hiatal hernia Obesity Smoking Heartburn Substernal burning pain associated with GERD may mimic pain of cardiac origin Chemical erosion of teeth 2/13/2025 6
The Patient With Gastrointestinal Disease (GERD and PUD) PUD H. pylori infection COX-1 inhibitors Stress, smoking, alcohol, caffeine, Zollinger-Ellison syndrome Abdominal pain Pallor of oral soft tissues 2/13/2025 7
The Patient With Gastrointestinal Disease (GERD and PUD) 2/13/2025 8
The Patient With Gastrointestinal Disease (GERD and PUD) Treatment strategies Avoid COX-1 inhibitors Direct gastric epithelial cell damage Decreased prostaglandin synthesis gastric acid secretion bicarbonate mucus blood flow 2/13/2025 9
The Patient With Gastrointestinal Disease (GERD and PUD) Preventive strategies Oral hygiene Conventional vs. electromechanical toothbrushes Antibacterial mouthwashes Topical fluorides Sialagogues Pilocarpine (Salagen) Cevimeline (Evoxac) 2/13/2025 10
