Gastrointestinal - GORD

Question 1

Symptoms ?

Answer 1

Heartburn, regurgitation, water brash (excess saliva), chest pain, Dyspepsia (pain)

Question 2

Non pharmacological treatments ?

Answer 2

Weight loss/ Smoking cessation/ avoid spicy fatty foods/ Avoid meals befor bed

Question 3

Pharmacological treatments ?

Answer 3

Immediate : Antacids (Gaviscon). Neutralise stomach acid. Liquid formulation faster. Tablet easier to use

Omeprazole PPI. 20mg OD 4 weeks. Have 30min - 1HR before bed.

Alternative treatment if fail = H2 Receptor Antagonist

Question 4

Special management approaches ?

Answer 4

When required approach = Use PPI’s only when symptoms appear

Step down approach = Reduce PPI dose gradually while maintaining lifestyle modifications

Question 5

What should be monitored while on long term PPI treatment ?

Answer 5

Serum magnesium levels

Question 6

What disease is long term PPI use linked to in older patients ?

Answer 6

Chronic kidney disease (CKD)

Question 7

MOA of PPI’s ?

Answer 7

Irreversibly inhibit H/K-ATPase Proton pump, blocking acid secretion.