Barrett Esophagus

Surgical and Endoscopic Therapies for GERD

Author/s: 
Sri Ganeshamurthy Thrumurthy, Yuto Shimamura, Jimmy Bok Yan So

Gastroesophageal reflux disease (GERD) affects quality of life and may cause erosive esophagitis, Barrett esophagus, and esophageal strictures and adenocarcinoma.1 The American Society for Gastrointestinal Endoscopy (ASGE) recommends initial management with behavioral modifications (eg, avoidance of meals within 3 hours of bedtime, elevating head of bed while asleep)2 prior to or combined with medications, such as proton pump inhibitors (PPIs), histamine-2 receptor antagonists, or potassium-competitive acid blockers (eg, vonoprazan). However, up to 54.1% of patients have persistent, troublesome symptoms (ie, heartburn or regurgitation for ≥2 d/wk) despite optimal medical therapy.3

Bisphosphonates for Postmenopausal Osteoporosis

Author/s: 
Ensrud, KE, Crandall, CJ

Bisphosphonates are the first-line pharmacologic treatment for postmenopausal osteoporosis and the most commonly prescribed medication for this condition.1 Bisphosphonates, classified as antiresorptive agents, have a very high affinity for bone mineral and bind to hydroxyapatite crystals on bony surfaces, where they inhibit osteoclast-mediated bone resorption.

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