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A New Look at Gastroesophageal Reflux: Old Wine in a New Bottle

Increasing data support the notion that sleep-related reflux is almost invariably associated with prolonged acid mucosal contact and prolonged acid mucosal contact creates a greater risk of reflux gastric acid into the tracheobronchial tract (Johnson and Harmon 1985; Orr et al., 2000). Gastroesophageal reflux disease (GERD) disrupts sleep with clinical complaints of sleepiness and sleep interferes with rapid removal of acid from the esophagus. The clinician needs to be aware of the role of sleep in GERD to be able to diagnose significant and potentially risky GERD and to formulate an appropriate treatment regimen.

This activity from the National Sleep Foundation, in joint sponsorship with the Atlanta School of Sleep Medicine, is intended to provide a knowledge-based educational format focusing on the aforementioned topics.

This program was presented at a satellite symposium at the American College of Physicians’ Internal Medicine 2009 meeting on April 23, 2009 in Philadelphia, PA. This program is now available online, free of charge to registered participants and should take approximately one hour to complete.

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Target Audience

This activity has been designed specifically for physicians.

Learning Objectives

Upon completion of this activity, health care providers will be able to:

  • Cite three symptoms and complications of nighttime gastroesophageal reflux.
  • Recognize presenting symptoms and warning signs of nighttime gastroesophageal reflux for diagnosis.
  • Articulate how treatment recommendations may be altered in patients with nighttime heartburn and gastroesophageal reflux.

Faculty

William C. Orr, PhDWilliam C. Orr, PhD

Lynn Health Science Institute

University of Oklahoma Health Sciences Center

William C. Orr, Ph.D. is the President and Chief Executive Officer of the Lynn Health Science Institute.  He is currently a Clinical Professor of
Medicine at the University of Oklahoma Health Sciences Center and Adjunct Professor at the United States Air Force Academy.  Dr. Orr has published extensively in both sleep disorders medicine and in gastrointestinal diseases.  He has served on the Board of Directors of the National Sleep Foundation for over 10 years.  He is a Fellow in the American College of Gastroenterology and on the advisory board/panel of several pharmaceutical and
medical service companies.

 

Lawrence F. Johnson, MD, FACPLawrence F. Johnson, MD, FACP

Professor of Medicine

University of Alabama at Birmingham, Medical School

Lawrence Johnson, MD, FACP, is a professor at the University of Alabama Birmingham, Medical School, where he specializes in gastroenterology and specifically swallowing, dysphagia, and esophageal disease.  He is a graduate of the Medical College of Virginia, and is certified by the American Board of Gastroenterology and the American Board of Internal Medicine.

 

Joel E. Richter MD, FACP, MACGJoel E. Richter MD, FACP, MACG

Richard L. Evans Professor

Chairman, Department of Medicine

Temple University School of Medicine

Joel E. Richter, MD, FACP, MACG, is a Richard L. Evans Professor and Chairman in the Department of Medicine Temple University School of Medicine.  He is the former Chairman of the Department of Gastroenterology and Hepatology at the Cleveland Clinic Foundation, and former President of the American College of Gastroenterology.  He has spent 25 years of his career in esophageal diseases and clinical research with over 400 publications.

 

Disclosures

It is the policy of the Atlanta School of Sleep Medicine to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participating in programs sponsored or jointly sponsored by Atlanta School of Sleep Medicine are expected to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation(s). Having an interest in or affiliation with any corporate organization does not necessarily influence a speaker’s presentation, but the relationship must be made known in advance to the audience in accordance with the standards of the Accreditation Council for Continuing Medical Education. It is the policy of the Atlanta School of Sleep Medicine that all faculty disclose the following information (1) if the CME content over which the speaker has control contains information about healthcare products or services, (2) if so, the financial relationship of individual and spouse/partner in the last 12 months with manufacturers of products or providers of services must be stipulated; and (3) attestation whether any identified relationship would cause information about healthcare products and services in the CME content to be commercially biased.

William C. Orr, PhD (planner and presenter) has disclosed that the CME content over which he has control does contain information about healthcare products or services and that he or his spouse/partner has had a financial relationship in any amount during the last 12 months with the manufacturers of the products or providers of the services that may be discussed. Dr. Orr discloses that he is a consultant for Takeda and Santaurus, on the Speakers’ Bureau for Takeda, Santaurus and Astra-Zeneca and has research grants with Takeda but attests that none of these relationships will cause the information about healthcare products and services in the CME content over which he has control to be commercially biased.

Joel E. Richter, MD (presenter) has disclosed that the CME content over which he has control does contain information about healthcare products or services and that he or his spouse/partner has had a financial relationship during the last 12 months with the manufacturers of the products or providers of the services. Dr. Richter discloses that he is on the Speakers’ Bureau for Astra-Zeneca and Takeda but attests that none of these relationships will cause the information about healthcare products and services in the CME content over which he has control to be commercially biased.

Christopher Drake, PhD (planner) has disclosed that the CME content over which he has control does contain information about healthcare products or services and that he or his spouse/partner has had a financial relationship during the last 12 months with the manufacturers of the products or providers of the services. Dr. Drake discloses that he is a consultant, speaker and researcher for Cephalon, a consultant for sanofi-aventis and has a research grant from Takeda but attests that none of these relationships will cause the information about healthcare products and services in the CME content over which he has control to be commercially biased.

Joseph Ojile, MD (planner) and Russell Rosenberg, PhD (planner) and staff planners David Cloud, Darrel Drobnich, Inne Barber, Jen Cowher, Trina Mercer, and Gail Reid have disclosed individually that the CME content over which they have control does not contain information about healthcare products or services.

Accreditation Statements

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Atlanta School of Sleep Medicine and the National Sleep Foundation. The Atlanta School of Sleep Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Designation of Credit
The Atlanta School of Sleep Medicine designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Credits valid from April 23, 2009 through April 23, 2011.

Participant Resources

For further information, please visit www.sleepfoundation.org and the NSF store www.sleepfoundation.org/sleepshop.

Educational Resources for Physicians:

Educational Resources for Physicians' Patients:

Commercial Support

This CME activity is supported by independent educational grants from Takeda Pharmaceuticals North America, Eisai, and AstraZeneca Pharmaceuticals.

Contact Information

For more information about this program, please email ibarber@sleepfoundation.org.

For technical questions or support, please email onlinecmehelp@sleepfoundation.org.

Technical Support

Minimum system requirements
For this activity, your computer needs to have Internet Explorer 6.0 (or higher) or Mozilla Firefox 2 (or higher) or Safari 2 (or higher) and Adobe Flash Player 9.0 (or higher). If you are using a modem to connect to the Internet, you will need a modem speed of at least 56K to view the pages of the site. Video content requires DSL and higher. Adobe Flash Player is required to view the video and Adobe Reader is required to print your certificate. You can download Adobe Reader for free. As you will be printing your CME certificate online, your computer must be connected to a printer.

Technical Questions
For technical questions or support, please contact us at: onlinecmehelp@sleepfoundation.org.