Gastro - GORD Flashcards
What are the oesophagus and stomach lined with?
Oesophagus
Squamous epithelial
Stomach
Columnar epithelial
What can cause GORD?
Hiatus hernia
Greasy and spicy foods
Alcohol
NSAIDs
Coffee and tea
Stress
Smoking
Obesity
What term is used to describe indigestion?
Dyspepsia
What are the symptoms of GORD?
Heartburn
Acid regurgitation
Retrosternal or epigastric pain
Bloating
Nocturnal cough
Hoarse voice
Halitosis
What are the red flag features of GORD?
Dysphagia
Over 55
Weight loss
Upper abdominal pain
Reflux
Treatment-resistant dyspepsia
Nausea and vomiting
Upper abdominal mass
Low Hb
Raised platelet count
What do the red flag features of GORD suggest?
Suspected cancer
Two week wait referral
What is an OGD?
Oesophago-gastro-duodenoscopy
Camera inserted through mouth down to duodenum
What is an OGD used for?
Assess for :
- Gastritis
- Peptic ulcers
- Upper GI bleeding
- Oesophageal varices
- Barrett’s oesophagus
- Oesophageal stricture
- Malignancy of the oesophagus
If patients have evidence of upper GI bleeding what should be done?
Admission
Urgent endoscopy
Melaena
Coffee ground vomiting
What are the 4 types of hiatus hernia?
Type 1
Sliding
Type 2
Rolling
Type 3
Sliding and rolling
Type 4
Large opening with additional abdominal organs entering thorax
What may hiatus hernia be seen on?
CXR
CT scan
Endoscopy
Barium swallow test
What is the management of GORD?
Lifestyle changes
Medication review
Antacids
PPIs
Histamine H2-receptor antagonists
Surgery
What lifestyle changes are indicated in GORD?
Reduce tea, coffee and alcohol
Weight loss
Avoid smoking
Smaller, lighter meals
Avoid heavy meals before bedtime
Stay upright
What surgery is done for GORD?
Laparoscopic reverse fundoplication
What type of bacteria is Helicobacter pylori?
Gram-negative aerobic bacteria