PRACTICUM 5: GERD CASE There are five therapeutic targets for GERD patients when considering planning, changing or discontinuing therapy, namely: 1. Overcoming symptoms 2. Repair of esophageal lesions 3. Prevent disease recurrence 4. Improve the patient's quality of life 5. Prevent the development of complications GERD therapy management consists of non-pharmacological therapy, pharmacological therapy, endoscopy, and surgery. 1. Non-pharmacological therapy Overcoming obesity/excess body weight, raising the head position (around 15-20 cm) during sleep, stopping smoking, stopping drinking alcohol, reducing food intake and medication that can trigger an increase in stomach acid and cause reflux, and eat the last meal 3 hours before bed. 2. Pharmacological therapy Drugs that can be used to treat GERD symptoms are antacids, prokinetics, H2 receptor antagonists, proton pump inhibitors, and baclofen. Implementation of Practicum a. Case Mrs. KR (48 years old) came to the hospital with the main complaint of heartburn accompanied by a burning sensation in the neck and back. This pain has been felt since 2 months ago and has gotten worse over the last 14 days, especially at night when the patient lies down. Patients experience these symptoms at least 4 times a week. These symptoms make it difficult for the patient to sleep so that during the day the patient feels tired. Patients also report that they sometimes experience regurgitation after eating which is accompanied by a bitter taste in the mouth and sometimes the patient feels short of breath. The patient has tried taking antacids 3 times a day before meals for the last 2 weeks, but the symptoms have only improved temporarily. The following are patient data: a. The patient admitted that he had no history of gastrointestinal disorders b. Patient's occupation: private employee c. Patient's medical history: Type 2 diabetes mellitus for the last 2 years d. Previous treatment history: 1) antacids for heartburn 3x/day since 2 weeks ago, 2) metformin 500 mg 3x1 and glibenclamide 5 mg 1x1 for the last 1 year (the patient still has medication from the control 1 week ago) e. The patient stated that he did not take NSAIDs f. The patient's weight is 70 kg, height 150 cm g. The patient stated that there was no blood in the stool h. The doctor diagnosed the patient as having GERD with moderate symptoms i. Medications currently prescribed by doctors: