Gastroesophageal Reflux Disease ▪️Not all heartburn = GERD ▪️DDx for heartburn & regurg ▪️EGD: 👀 objective GERD findings ▪️pH testing (OFF PPI) ▪️Objective dx of GERD ▪️Acid suppression (PPI, H2RA, etc) ▪️Lifestyle modifications ▪️🔪 options ▪️GERD pathophysiology #GITwitter

Carvedilol preferred NSBB! ▪️Reduces vascular resistance too ▪️Start: 6.25 mg once daily ▪️Titrate to 6.25 mg BID ▪️Max dose: 12.5 mg/day ▪️No HR target needed ▪️Maintain SBP ≥90 mmHg ▪️Adverse: ortho BP, constipation ▪️No endoscopy if on therapy #DDW2025

🧪Fecal elastase-1 is a sensitive test for pancreatic exocrine insufficiency (#PEI) 📊 In a meta-analysis: 200 µg/g → Sens. 94%, Spec. 69% 100 µg/g → Sens. 88%, Spec. 82% ⚠️Moderate specificity → interpret in clinical context 📖 #OpenAccess 👉bit.ly/4mRZhPg