Oral Medicine | GERD & Peptic Ulcers | INBDE

Summary

This video covers gastrointestinal diseases such as gastroesophageal reflux disease (GERD) and peptic ulcer disease. It explains how stomach acid affects the esophagus and teeth, discussing the causes, risks, and medications involved in treatment. Emphasis is placed on the oral implications of these diseases, including tooth erosion and dry mouth. The video also highlights the role of lifestyle factors, such as diet and medication use, in managing these conditions. Additionally, it explores the link between GERD, obstructive sleep apnea, and teeth grinding, offering practical advice for patients and healthcare providers.

Takeaways

• 😀 Acid reflux occurs when stomach acid leaks upward into the esophagus, leading to heartburn and tooth erosion.
• 😀 Peptic ulcer disease involves a breakdown of the stomach lining, usually due to H. pylori infection or NSAID use.
• 😀 Helicobacter pylori bacteria can protect itself from stomach acid by secreting ammonia, causing stomach lining damage.
• 😀 NSAIDs can increase the risk of peptic ulcers by inhibiting prostaglandins that protect the stomach lining.
• 😀 Proton pump inhibitors (PPIs) are highly effective for acid reflux and ulcers, but they come with significant drug interactions.
• 😀 Medications like amoxicillin and metronidazole can treat H. pylori infections in peptic ulcer disease.
• 😀 Over-the-counter H2 blockers like ranitidine can help with acid reflux by reducing acid secretion in the stomach.
• 😀 A patient's diet, including acidic foods, can exacerbate acid reflux and tooth erosion, and should be considered during treatment.
• 😀 Common oral manifestations of gastrointestinal diseases include tooth erosion, dry mouth, and fungal infections like candidiasis.
• 😀 The 'sleep acid triad' links acid reflux, obstructive sleep apnea, and nocturnal teeth grinding, with strong correlations between the three.
• 😀 Age-related factors, such as polypharmacy in the elderly, increase the risk of dry mouth and tooth erosion due to reduced salivary buffering capacity.

Q & A

What is gastroesophageal reflux disease (GERD)?

GERD, or acid reflux, is a condition where gastric acid leaks upwards from the stomach into the esophagus, throat, and mouth, causing symptoms like heartburn and tooth erosion.

How does the stomach normally handle gastric acid without causing damage to itself?

The stomach is lined with a protective mucous gel that shields it from the acidic environment, allowing it to safely produce gastric acid for digestion.

What are the common causes of peptic ulcer disease?

The most common causes of peptic ulcer disease are infection with *Helicobacter pylori* and chronic use of NSAIDs, both of which weaken the stomach's protective lining, allowing acid to cause damage.

How does *Helicobacter pylori* contribute to peptic ulcers?

*Helicobacter pylori* produces ammonia to protect itself from stomach acid. This weakens the protective mucus layer of the stomach, allowing acid to damage the stomach lining and cause ulcers.

What are some common medications used to treat GERD and peptic ulcers?

Common medications include antibiotics like amoxicillin and metronidazole to treat *H. pylori*, histamine 2 blockers (e.g., ranitidine) to reduce stomach acid, and proton pump inhibitors (e.g., omeprazole) for stronger acid suppression.

What are the side effects of proton pump inhibitors (PPIs)?

PPIs, such as omeprazole, can interfere with the absorption of certain medications like ampicillin and ketoconazole. They also have more drug interactions and can increase the concentration of medications like benzodiazepines and warfarin.

How does acid reflux affect oral health?

Acid reflux can lead to tooth erosion due to the regurgitation of gastric acid, which wears down the enamel. This can also cause dry mouth (xerostomia), increasing the risk of cavities and periodontal disease.

What are the key oral manifestations of gastrointestinal diseases like GERD and peptic ulcers?

Oral manifestations include tooth erosion from gastric acid (perimolysis), fungal overgrowth leading to candidiasis, altered taste perception, and potential dry mouth due to medications like PPIs.

What is the 'sleep acid triad' in relation to GERD?

The 'sleep acid triad' refers to the strong correlation between GERD, obstructive sleep apnea (OSA), and nocturnal bruxism (teeth grinding), where all three conditions often occur together.

Which patient groups are most at risk for tooth erosion due to acid reflux?

Teenagers (due to eating disorders and sugary drink consumption), middle-aged people (due to GERD and OSA), and the elderly (due to polypharmacy and xerostomia) are at higher risk for tooth erosion related to acid reflux.