Acid reflux is prevented by all except:
Ans: d (Increased intra-thoracic pressure) Ref: Bailey, 24th ed, p. 999Intra-abdominal pressure compresses the intra-abdominal segment of LES and is probably the most important factor in preventing reflux.Dyspepsia with fatty foods is more common in GERD than gall stone disease.Diagnostic measurement in GERD24 hour pH recording- gold standard for diagnosisTransient lower esophageal sphincter relaxation (TLOSR) is the most important manometric finding.Treatment:Medical: PPI are most effectiveTilting the bed- head end elevationSurgical: Allison repair--not done nowNissen fundoplication- total- partialHill procedureBelsey Mark IV
Long intra-abdominal esophagus
Increased intra-abdominal pressure
Right crus
Increased intra thoracic pressure
Stomach & Duodenum