Gastro-oesophageal reflux disease and dysmobility of oesophagus Flashcards
what type of medication is used for reflux?
proton pump inhibitor (PPI)
what does reflux quality of life compare to?
acute coronary syndrome
what is GORD?
gastro-oesophageal-reflux disease
what does GORD cause?
incompetent lower oesophageal sphincter
poor oesophageal clearance
Barrier function/visceral sensitivity
what are the symptoms of GORD?
heart burn/acid reflux waterbrash dysphagia odynophagia weight loss chest pain hoarseness coughing
how is GORD investigated?
endoscopy
Ba swallow
oesophageal manometry and pH studies
nuclear studies
what symptoms of reflux would cause alarm?
dysphagia weight loss anaemia vomiting F/H UGI cancer Barrets oesophagus pernicious anaemia PUD surgery >20 years
what can be done for oesophageal carcinoma?
radiotherapy
surgery
palliation
what is the prognosis of oesophageal adenocarcinoma?
perioperative = 5-10% mortality
5 year survival = 5-10%
subclinical = 80-90%
what is the trend in oesophageal adenocarcinoma incidence?
increasing
what is the trend in squamous cell carcinoma incidence?
decreasing
what is the pathogenesis of adenocarcinoma?
normal > oesophagitis (reversible) > barrets (irreversible) > adenocarcinoma (too late)
how is GORD managed?
symptom relief
heal oesophagitis
Prevent complications
what lifestyle modifications can improve GORD?
stop smoking
loose weight
prop up bed head
avoid provoking factors
what do antacids do?
symptomatic relief for majority of reflux patients
no healing/preventative effects