Abdominal Flashcards
1
Q
What causes GORD?
A
- Failure of lower oesophageal sphincter
- Not increased acid, increased acid AND pepsin
- Hiatus hernia - when gastro-oesophageal junction prolapsed through hiatus alongside oesophagus
- decreased saliva/motility
- delayed stomach emptying
- hypersensitive oesophagus
2
Q
What are the risk factors for GORD?
A
⬆️ intra abdominal pressure
Inadequate cardiac sphincter
Poor oesophageal peristalsis
Smoking Alcohol Diet; fat, large meals, caffeine Pregnancy Obesity Tight clothes Drugs; TCAs, anticholinergics, nitrates,m
3
Q
What are the symptoms of GORD?
A
Heartburn Dysphagia Odynophagia Non-specific chest pain Bloating Chronic cough
4
Q
What are the possible differential diagnoses of GORD?
A
Oesophagitis Peptic ulcer GI malignancy Non-ulcer dyspepsia Oesophageal spasm
5
Q
What investigations are necessary to diagnose GORD?
A
Rule out cancer red flags
pH checks
Endoscopy
Barium swallow
6
Q
What are the treatments of GORD?
A
Pharmacological
- alignates (gaviscon)
- antacids
- PPIs
Prophylaxis
- smaller meals
- lose weight
- raise head of bed
Surgery
7
Q
How common is GORD and who does it affect?
A
20-40% report heartburn in 6-12month period
Male:Female 2:1
8
Q
What are the distinguishing features of Crohn’s disease?
A
- It is present throughout bowel and GI system
- any part of gut, mouth to anus (70% terminal ileum)
- smoking a risk factor
- diarrhoea/urgency (wake early), weight loss
- aphthous ulcers, clubbing
Treatment: - quit smoking, optimise nutrition
- prednisolone (mild attacks)
- NBM, IV steroids (severe unwell)
9
Q
What are the distinguishing features of Ulcerative Colitis?
A
- localised to colon
- common in non-smokers (smoking protective)
- episodic/chronic diarrhoea (+/- mucus/blood), crampy abdo pain, systemic symptoms in attacks
- abdo tender and distended, clubbing, cancer risk
Treatment: - Aminosalicylates (sulfasazaline, induces remission)
- oral prednisolone (moderate)
- suppositories
- surgery
