2017-03-08 15:59:06 UTC

Test Your EndoFLIP Knowledge

March 8, 2017

Apply the best practice advice in the AGA Clinical Practice Update on the management of esophageal disorders using EndoFLIP by taking this short quiz.

See if you can answer this question correctly, based on the latest Clinical Practice Update for the use of the functional lumen imaging probe (FLIP) to assess disorders of the upper gastrointestinal tract, which was published in the March issue of Clinical Gastroenterology and Hepatology.

Question: A 28-year-old man with dysphagia and postural regurgitation over 6 months presents to your office for evaluation. He was initially diagnosed with GERD and started on double dose proton pump inhibitor with no improvement over 3 months and stopped the medicine 1 month ago. Physical examination is unremarkable. An upper endoscopy is performed and is normal without evidence of esophagitis or hiatal hernia. Mucosal biopsies are normal. His manometry revealed severe ineffective esophageal motility with 8 absent swallows and 2 ineffective swallows (distal contractile integral, or DCI) values of 356 and 423 mmHg-cm-sec. The median integrated relaxation pressure (IRP) was 11 mmHg. A timed barium esophagram showed tertiary contactions and a 5cm column of barium at 1 minute that cleared at the 2 minute time point.

What would be the next step for this patient?

A. Referral to rheumatology for evaluation of scleroderma.
B. Referral for cognitive behavioral therapy for functional dysphagia.
C. 24 hour pH-impedance to assess for refractory GERD.
D. Repeat endoscopy with EndoFLIP to rule out achalasia or an EGJ obstruction. 
E. Endoscopic ultrasound to rule out an underlying submucosal or extrinsic lesion.

Check out the AGA Community forum to see if you answered correctly, and then post your questions regarding the Clinical Practice Update on using EndoFLIP for esophageal disorders. Remember that anonymous posting is available.

More on GERD

Psychotherapy helps patients with chronic digestive disorders

April 17, 2018

New AGA Clinical Practice Update explains benefits of psycho- gastroenterology for patients.

Course for APPs benefits all experience levels

April 16, 2018

AGA's popular course for advanced practice providers will take place Aug. 10 through 12 in Chicago, Illinois.

APPs: Enhance your delivery of patient care

March 28, 2018

AGA's popular course for advanced practice providers will be held this summer in Chicago.