GERD: Gastroesophageal Reflux Disease: Role of Saliva & Gastric Acid in Digestion & Erosive Disorders Affecting Tooth, Stomach, and Esophagus

Format Publication ID Version Published
Tutorial, Case 9266 1 November 14, 2012

Description

This student-centered, small-group activity supports goals set forth in Report IX, Contemporary issues in medicine: oral health education for medical and dental students. The exercise uses disorders of gastric acidity to (i) highlight oral-systemic connections in collaborative patient care, and also to (ii) impart requisite foundational knowledge and clinical reference that enable an understanding of the oral manifestations of systemic diseases and oral-systemic interactions. The target audience is any health professions student who seeks to attain those cross-cutting competencies that promote the common attitudes, knowledge, and skills necessary to prepare for effective practice and interprofessional collaboration in today’s health care environment. Imparting these competencies to students will contribute to the general aim of Building Oral Health Capacity (BOHC) in our health care delivery system.

GERD happens when a LES (lower esophageal sphincter) defect permits gastric acid reflux to the esophagus. The consequences and/or complications include: heartburn, cough (irritated throat, larynx, epiglottis), asthma (bronchial irritation), dental erosion, bad breath, bad tastes, and more serious, a precancerous condition known as Barrett’s Esophagus, and ultimately esophageal cancer. A careful oral examination, whether by physician or dentist, can provide the initial GERD diagnosis, which is key to preventing progressive illness. This exercise addresses key issues in the biochemistry, physiology, pharmacology, and management of gastric acidity. A clinical vignette, The Case of Gerdy Williams, unfolds along with these scientific issues.

This is a highly-constrained, student-centered, activity consisting of a take-home tutorial (instructional text, questions, detailed answers) on GERD and its scientific underpinnings plus a small-group activity in which instructors are to act as group facilitators—not purveyors of knowledge. The included student-resources (scientific content with clinical reference, study-questions, detailed answers) enable instructor-independent study at home. This “homework” prepares the student for small group activity. The instructor-resources (step-by-step session timeline, pre-written quizzes, answers, and listed learning issues) create conditions for productive, student-centered discussion that can be facilitated by non-expert faculty (group leaders). A novel 3-quiz paradigm, included in the session timeline, provides incentives for students to do each of three important things: (i) study at home so as to arrive prepared, (ii) share knowledge in the group discussion, and (iii) and profit from the discussion by actively engaging peers in thoughtful give and take.

Citation

King S. GERD: Gastroesophageal Reflux Disease: Role of Saliva & Gastric Acid in Digestion & Erosive Disorders Affecting Tooth, Stomach, and Esophagus . MedEdPORTAL; 2012. Available from: www.mededportal.org/publication/9266

Educational Objectives

  1. To define what GERD is and contrast it to silent-GERD.
  2. To describe the reversible and irreversible oral manifestations of GERD.
  3. To describe the common purpose of tooth and acid in the digestive process.
  4. To explain how the parietal cell makes HCl, and how this process is regulated.
  5. To describe the specializations that make the stomach more acid-resistant than the esophagus and how compromise of these protections will lead to disease.
  6. To explain non-medical interventions that a patient can use to ameliorate GERD symptoms.
  7. To describe medical treatments and interventions that a physician can recommend or perform to ameliorate gastric acidity and GERD symptoms.

Keywords

  • GERD (MeSH), Gastric Ulcer (MeSH), Digestion (MeSH), Stomach (MeSH), Esophagus (MeSH), Omeprazole (MeSH), Bisphosphonate, Helicobacter Pylori, Tooth Decay, Gastric Acid, Building Oral Health Capacity (BOHC) Collection

Specialty

  • Medical
    • Family Medicine
    • Gastroenterology

Discipline

  • Dental
    • Assessment, Diagnosis & Treatment
    • Establishment & Maintenance of Oral Health
    • Patient Care
    • Pharmacology

Competencies Addressed

  • Medical
    • Medical Knowledge
    • Patient Care
    • Practice-based Learning & Improvement

Academic Focus

  • Basic Sciences
    • Biochemistry/Cell Biology
    • Microbiology
    • Pharmacology/Toxicology
    • Physiology
  • Clinical Sciences
    • Clinical Skills/Doctoring

Professional Interest

  • Interdisciplinary
  • Oral Health

Organ Systems

  • Gastrointestinal system

Intended Audience

  • Professional School
    • Dental Student
    • Medical Student

Instructional Methods

  • Assessment
  • Independent Study
  • Team-based Learning

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