GERD

Question 1

What are the causes of gastro-oesophageal reflux?

Answer 1

• weak lower esophigal sphincter - ring seperating esophagus from stomach —-> weak LES allows stomach contents to flow into eosophagus —-> reflux
• obesity - excess body weight near abdomen increases pressure on stomach and LES
• pregnancy - pressure of growing uterus on stomach

Question 2

what is an OGD?

Answer 2

medical procedure involving examination of esophagus, stomach and duodenum using a flexible endoscope

Question 3

what is normal epithelial lining of oesophagus?

Answer 3

stratified squamous epithelia

Question 4

risks of GERD

Answer 4

• barrett’s esophagus
• respiratory issue

Question 5

presence of small rod-shaped object in gastric biopsies, particularly within mucus layer suggests presence of…

Answer 5

H. pylori bacteria

Question 6

treatment for H.pylori bacteria

Answer 6

• antibiotics - clarithromycin, metronidazole
• proton pump inhibitors - reduce stomach acid production for more favourable environment for antibiotics to work

Question 7

how does H.pylori survive in stomach?

Answer 7

• produces urease which breaks down urea into ammonia —-> ammonia helps neutralise acidic environment in stomach
• highly motile, has flagella
• can adhere to surface of epithelial cells in stomach lining

Question 8

omezaprole

Answer 8

• proton pump inhibitor used to treat GERD associated conditions
• stop gastric acid secretion by selective inhibition of the H+/K+ ATPase enzyme system

Question 9

What other drugs can be used to treat problems with acid reflux and how do they work?

Answer 9

• antacids - neutralise stomach acid
• H2 blockers - reduce production of stomach acid

Question 10

What type of antibiotic is clarithromycin and what part of the organism does clarithromycin act on?

Answer 10

• macrolide antibiotic
• inhibits bacterial protein synthesis by binding to the bacterial 50S ribosomal subunit