Gastro-oesophageal Reflux Disease Flashcards
What causes GORD?
Incompetent lower oesophageal sphincter, poor oesophageal clearance
Symptoms of GORD
Heartburn, acid reflux, waterbrash, dysphagia, odynophagia, weight loss, chest pain, hoarseness, coughing
Investigations for GORD
Endoscopy, barium swallow, oesophageal manometry and pH studies, nuclear studies
Alarm symptoms for GORD
Dyspepsia, dysphagia, peptic ulcer disease surgery >20 years, pernicious anaemia, Barrett’s oesophagus, vomiting, weight loss, family history of upper GI cancer
Oesophageal carcinoma:
- Which gender is most affected?
- Treatment
- 5 year survival
- Males
- Radiotherapy, surgery, palliation
- Very low
Management of GORD
Symptom relief, healing oesophagitis, prevent complications
Lifestyle modification for GORD
Stop smoking, weight loss, prop up bed head, avoid provoking factors
Drugs that can be given to treat GORD
Antacids, H2 antagonists
Why are antacids given in GORD?
Symptom relief
H2 antagonists examples
Cimetidine, ranitidine
Which surgery can be given to treat GORD?
Nissen fundoplication
When is Nissan fundoplication given?
In young patients or severe/unresponsive disease
Management for dysplasia
More frequent surveillance, optimise PPI dose, endoscopic mucosal resection, radiofrequency ablation
Gastroparesis
Delayed gastric emptying
Symptoms of gastroparesis
Feeling full, nausea, vomiting, weight loss, upper abdominal pain
