1. Gastro-oesophageal reflux

Question 1

How common is it?

Answer 1

Very - most common form of oesophagitis

Up to 1 in 4/5 UK adults

Question 2

Who gets it?

Answer 2

Common in western populations
Roughly 1M:1F but could be slightly higher in men
Men more likely to develop Barrett’s

Question 3

What causes it?

Answer 3

Infectious (bacterial, viral (HSV1, CMV), fungal (candida))

Chemical (ingestion of corrosive substances, reflux of gastric contents)

Question 4

What risk factors are there?

Answer 4

Obesity, pregnancy
Hiatus hernia, defective lower oesophageal sphincter
Gastroparesis

Question 5

How does it present?

Answer 5

Heartburn, regurgitation

Epigastric pain, dysphagia, odynophagia, belching

Question 6

What signs would the patient have on examination?

Answer 6

Inflammation at GE junction on endoscopy
Teeth erosion
Halitosis

Question 7

What other conditions might present similarly?

Answer 7

Coronary artery disease
Gastric / oesophageal cancer
Gastroparesis
Achalasia
Peptic ulcer disease

Question 8

How would you investigate?

Answer 8

Upper endoscopy
Ambulatory acid probe test
X-ray

Question 9

What treatments would you discuss?

Answer 9

Lifestyle modification - weight loss, eating routine, diet
PPIs, H2RAs
Surgery - fundoplication, bariatric surgery,