Gastroenterology 12 - GORD

Question 1

6 aspects in GORD presentation

Answer 1

acid regurg
heartburn
retrosternal/epig pain
bloating
nocturnal cough
hoarse voice

Question 2

define GORD

Answer 2

stomach acid refluxes through the lower oesophageal sphincter and irritates lower oesophageal lining

Question 3

which patients need very urgent endoscopy?

Answer 3

patients with evidence of GI bleed

melaena, coffee grounds

Question 4

red flag symptoms for endoscopy x8

Answer 4

dysphagia 
over 55
weight loss
upper abdo pain
treatment resistant dyspeps
nausea, vomiting
low Hb
high platelets

Question 5

6 bits of lifestyle advice for treating GORD

Answer 5

reduce tea, coffee, alcohol
weight loss
stop smoking 
smaller more reg meals
don't eat just before bed
stay upright after eating

Question 6

3 phases of GORD treatment

Answer 6

gaviscon, Rennies
lansoprazole
laparoscopic fundoplication

Question 7

tell me about H pylori

Answer 7

gram negative aerobe
invades gastric mucosa and exposes the epithelial
ammonia produced to neutralise stomach acid
damages lining

Question 8

3 options for H pylori testing

Answer 8

need 2 weeks off PPI first

urea breath test
stool antigen test
rapid urease test in endoscopy

Question 9

describe rapid urease CLO test

Answer 9

biopsy stomach mucosa tested for urease enzymes made by H pylori

Question 10

eradication therapy example for H pylori

Answer 10

PPI + amox + clarithromycin

Question 11

describe Barrett’s oesophagus

Answer 11

lower oesopageal squamous epithelium metaplasia to columnar

higher risk of transformation into adenocarcinoma

Question 12

treating Barrett’s oesophagus x3

Answer 12

PPIs
monitor with OGDs
ablation treatment if dysplastic