Gastro-oesophageal reflux (GORD) Flashcards
1
Q
What is GORD
A
- Oesophageal mucosal damage due to chronic reflux acid
- DYSPEPIA = pain/discomfort caused by reflux
2
Q
How common is it
A
- 10-20% population
3
Q
Who does it affect
A
- M=F mostly adults >40years
4
Q
What is the cause/aetiology of GORD
A
- failure of closure/weakening of lower oesophageal sphincter
5
Q
What are the risk factors for developing GORD
A
- Obesity, high fat diet, smoking, alcohol, coffee, stress, chocolate
- Pregnancy
- Hiatus hernia
- Systemic sclerosis
- Drugs - nitrates (GTN), BZs –> reduce sphincter tone
6
Q
What are the symptoms of GORD
A
- Heartburn - epigastrum (may radiate to neck, throat, jaw)
- Pain worse when lying down/bent over
Regurgitation - unpleasant taste
- Odynophagia - pain on swallowing
- Dysphagia
- Cough, nausea, hoarseness in morning
7
Q
What are some differential diagnoses
A
- Gastritis, oesphagitis
- CAD
- Achalasia
- Biliary colic
- Peptic ulcer disease
- Malignancy
8
Q
What are the investigations for GORD
A
- Mostly on Hx
- Endoscopy (+4weeks, dysphagia, weight loss, +55yrs)
- Manometry - measure strength + ability of sphincter
- Barium swallow
9
Q
What is the management/ treatment for GORD
A
- Lose weight, low fat diet, smoking cessation, avoid alcohol
- OTC antacids
- PPIs - lanzoprazole, omeprazole
- H2 receptor antagonist - ranitidine
- Surgery - last resort
