Gastro-oesophageal reflux disease (GORD) Flashcards
What is GORD?
Condition caused by acid from the stomach refluxing through the lower oesophageal sphincter and irritating the lining of the oesophagus
Name 2 things persistent GORD can cause
- Oesophagitis
- Benign oesophageal stricture
- Barrett’s oesophagus
- Ulceration
- Iron deficiency
- Oesophageal cancer
What is dyspepsia?
Non-specific term used to describe indigestion which covers the symptoms of GORD
Name 3 symptoms of GORD
- Heartburn worse after eating and lying down
- Acid regurgitation
- Odynophagia
- Retrosternal or epigastric pain
- Bloating
- Nocturnal cough
- Hoarse voice
- Chronic sore throat
1) What are the 2 mechanisms that can cause GORD?
2) Name 2 causes of these
1) Decreased lower oesophageal sphincter tone and increased intra-abdominal pressure
2) Obesity, hiatal hernia, pregnancy, oesophageal dysmotility, delayed gastric emptying, gastric acid hypersecretion, smoking, alcohol, drugs i.e. nitrates, tricyclics and anticholinergics
Name 2 lifestyle advice that would be given to someone with GORD
- Reduce tea, coffee and alcohol
- Weight loss
- Avoid smoking
- Smaller, lighter meals
- Avoid heavy meals before bed time
- Stay upright after meals rather than lying flat
1) Name an antacid that might be used in the treatment of GORD
2) Name an alginate that might be used in the treatment of GORD
3) Name a PPI that might be used in the treatment of GORD
4) Name a H2 antagonist that might be used in the treatment of GORD
1) Magnesium trisilicate
2) Gaviscon
3) Lansoprazole, pantoprazole, omeprazole
4) Ranitidine, cimetidine
Surgery for reflux is called laparoscopic fundoplication. What does this involve?
Tying the fundus of the stomach around the lower oesophagus to narrow the lower oesophageal sphincter
What is the gold standard for GORD diagnosis?
24hr pH monitoring
