Gastro-Oesophageal Reflux Disease (GORD)

Question 1

Gastro-oesophageal reflux disease (GORD)

Answer 1

Acid from the stomach leaks up into the oesophagus (gullet).

Question 2

Gastro-oesophageal reflux disease (GORD)

Pathology

Answer 2

It usually occurs as a result of the ring of muscle at the bottom of the oesophagus (LOS) becoming weakened.

Question 3

Gastro-oesophageal reflux disease (GORD) Complications

Answer 3

This can lead to the oesophagus forming ulcers, and the squamous epithelium thickening. Prolonged reflux may cause oesophagitis.
- Complications -
Carcinoma
Ulceration
Stricture
Glandular Metaplasia (Barret’s Oesophagus).

Question 4

Gastro-oesophageal reflux disease (GORD)

Investigations:

Answer 4

24-hour Oesophageal pH monitoring
Manometry - (measures the strength and muscle coordination of your esophagus when you swallow)
Endoscopy
Barium Swallow.

Question 5

Gastro-oesophageal reflux disease (GORD) Treatment:

Answer 5

Lifestyle
(Weight loss, Smoking cessation, Having small regular meals, Eating no later than three hours before bed time, sleeping with head elevated. Also avoid alcohol, spicy foods, chocolates)

Alginates (Gaviscon Advance)
Antacids (Magnesium Trisilicate Mixture), Anti-reflux surgery (Fundoplication)
Proton pump inhibitor (Lansoprazole)
H2RA (Ranitidine).