Gastroesophageal reflux disease Flashcards
What is GERD?
Retrograde flow of stomach contents into the oesophagus causes irritation to the epithelial lining
What are risk factors of GERD?
(Main cause) Transient lower esophageal sphincter relaxations (tLESRs)
(Risk factors) Lifestyle habits (i.e. smoking, caffeine + alcohol consumption)
Stress
Obesity
Pregnancy
Scleroderma ( chronic disease caused by abnormal growth of connective tissue)
Sliding hiatal hernia
What are the clinical features of GERD?
Retrosternal burning pain + worsens when lying down Pressure sensation on chest Regurgitation Non-productive / Nocturnal cough Halitosis
How is GERD diagnosed?
Clinical features
Endoscopy if dysphagia or >55yrs + alarm symptoms or treatment resistant dyspepsia
pH monitoring + manometry can help if endoscopy normal
What is the treatment for GERD?
(Lifestyle) Weight loss, smoking + alcohol cessation, small portion meals
(Medical) Antacids (e.g. magnesium trisilicate). alginates (e.g. gaviscon), PPI (lamsoprazole)
(Surgery) Laproscopic Nissen fundoplication (indications such as Barrett’s, strictures, aspiration)
What are the differential diagnosis of GERD?
Other forms of oesophagitis (infection, drug induced, eosinophilic)
Angina
Achalasia (failure of the lower esophageal sphincter to relax)