Purpose, Audience, Author, and Acknowledgements

Purpose
Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders in the United States. Several population surveys have revealed that many patients who report having symptoms of GERD are particularly bothered by symptoms that occur at night. In addition, nighttime GERD has been noted to have a negative impact on quality of life and specifically sleep quality. Nighttime GERD has also been shown to impair work productivity, thereby having a negative economic impact as well. Many of these surveys have also revealed that patients do not always seek medical advice for their symptoms and report using treatment approaches that are ineffective.

The symptoms and complications of GERD are not limited to the esophagus, but can involve organs that are in proximity to the esophagus. Nighttime GERD, in particular, has been associated with asthma and other respiratory symptoms. Supraesophageal symptoms, especially in the absence of typical GERD symptoms may not be recognized as a complication of GERD. On the other hand, recent data have suggested that many patients with possible extra-esophageal manifestations of GERD do not actually have the disorder.

This interactive program will focus on the clinical challenges posed by patients with nighttime GERD, as well as those with supraesophageal symptoms. The case-based format will help illustrate how to best incorporate evidence-based approaches into everyday practice.

Learning Objectives
After completing this program participants should be able to:

• Describe the proposed pathophysiologic mechanisms associated with nighttime GERD
• Critically appraise the impact of GERD on quality of life and work productivity
• Identify diagnostic strategies to evaluate patients with nighttime heartburn as well as patients presenting with supraesophageal complications of GERD
• Outline the challenges associated management of patients with nighttime GERD and/or supraesophageal complications of GERD
• Understand treatment options for patients and utilize this information to develop appropriate treatment paradigms

Audience
This self-study activity is appropriate for gastroenterologists, nurses, physician assistants and primary care physicians.

Program Planner
James M. Scheiman, MD
Professor of Medicine Division of Gastroenterology
University of Michigan Health System
Ann Arbor, Michigan

Faculty
Ronnie Fass, MD, FACP, FACG
Associate Professor of Medicine
Head, Neuro-Enteric Clinical Research Group
Director, GI Motility Laboratories
University of Arizona Health Sciences Center and
Southern Arizona VA Health Care Systems
Tucson, Arizona

Brien L. Neudeck, PharmD
Assistant Professor Departments of Pharmacy and Pharmaceutical Sciences
College of Pharmacy
University of Tennessee
Memphis, Tennessee

Reza Shaker MD, FACP, FACG
Professor and Chief,
Division of Gastroenterology and Hepatology
Director, Digestive Center Medical College of Wisconsin
Milwaukee, Wisconsin

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