Abdominal: Gastro-oesophageal Reflux Disease Flashcards
What is GORD?
Gastro-oesophageal reflux disease
- Chronic relapsing condition
- Stomach contents rises into oesophagus
What can cause GORD?
- hiatal hernia
- impaired oesophageal clearance
- delayed gastric emptying
- impaired mucosal defensive factors
What risk factors are associated with GORD?
- stress/anxiety
- drugs (Anti-inflammatories e.g. ibuprofen)
- fat, chocolate, coffee
- alcohol
- large meals
- smoking
- hiatus hernia
What advice would you give to a patient if they have GORD?
- eat smaller/more frequent meals
- raise head end of bed
- lose weight if over weight
- find ways to relax
What would you advise against if a patient has GORD?
- avoid food/drink that triggers symptoms
- don’t eat before bed
- don’t wear clothes tight around chest
- don’t smoke
- don’t drink too much alcohol
- don’t stop taking prescribed medicine without talking to a doctor first
How does GORD present?
- heartburn
- regurgitation of food/acid
- patient complains of pain when drinking hot liquids or alcohol
- bad breath
- hoarse throat
- bloating/belching/hiccuping
what is dyspepsia?
a group of symptoms that alert doctors to consider disease of the upper GI tract including:
- upper abdominal pain or discomfort, heartburn, gastric reflux, nausea, or vomiting.
what conditions present in a similar way to GORD?
- Hiatus hernia
- Cardiac Ischaemic pain
what investigations do you use to diagnose GORD?
Diagnosis can be made without investigation.
If needed:
- endoscopy
- intraluminal monitoring (pH of oesophagus)
when should you refer a patient with suspected GORD for an endoscopy?
If GORD presented with GI bleeding.
what intervention should be made for uninvestigated dyspepsia?
- 2 week of PPI
- test for H pylori
What over the counter medication can be used for GORD?
Alginate-containing antacids (10 mL three times daily)
what do antacids do?
- over-the-counter medication for GORD
- form a gel or ‘foam raft’ with gastric contents to reduce reflux
side effects of antacids?
Magnesium-containing antacids tend to cause diarrhoea.
Aluminium-containing compounds may cause constipation.
If antacids fail to treat GORD what else can be purchased over the counter?
H2-receptor antagonists
(e.g. cimetidine, ranitidine, famotidine and nizatidine) are frequently used for acid suppression
