Gastro-Oesophageal Reflux Disease

Question 1

Definition of GORD

Answer 1

Damaged oesophageal sphincter —> gastric content into oesophagus —> — pH

Question 2

Upper 2/3rd oesophagus normal muscle histology

Answer 2

Stratified

Question 3

Lower 1/3rd oesophagus normal muscle histology

Answer 3

Smooth

Question 4

Lifestyle causes of GORD

Answer 4

• large meals

- alcohol/caffeine/spicy

Question 5

Why does high BMI lead to GORD

Answer 5

+ pressure on sphincter due to stomach compression

Question 6

2 medical/physiological causes of GORD

Answer 6

• hiatus hernia

- delay gastric emptying

Question 7

How does schelederma lead to GORD

Answer 7

Autoimmune thickening of tissue —> sphincter incompetence

Question 8

Why do CC blockers lead to GORD

Answer 8

Relax LOS

Question 9

Gold standard Ix for GORD

Answer 9

24hr pH monitoring (NADP-pharynx catheter)

Question 10

What do endoscopy/barium meals look for

Answer 10

• ulcers
• Barrett’s
• tumour
• hiatus hernia

Question 11

Alternative to endoscopy/b meals

Answer 11

Biopsy

Question 12

Stomach related presentations of GORD

Answer 12

• heart burn
• water brash
• vomiting/regurgitation
• odynophagia

Question 13

Heart burn in GORD is worse when

Answer 13

After meals

Question 14

Larynx related symptoms of GORD

Answer 14

• chronic cough

- hoarse voice

Question 15

How do antacids (Gaviscon) treat GORD

Answer 15

Neutralise acid

Question 16

How does omeprazole treat GORD

Answer 16

Reduce P cell acid production

Question 17

Alternative to PPIs

Answer 17

Ranitidine

Question 18

Function of ranitidine

Answer 18

H2 receptor antagonist

Question 19

Metaplasia pattern in Barrett’s that improves symptoms slightly

Answer 19

Squamous —> columnar

Question 20

Barrett’s is premalignant as it increases the risk of … and therefore requires regular monitoring via

Answer 20

• adenocarcinoma

- endoscopy

Question 21

Barrett’s Tx

Answer 21

• PPIs

- ablation