GORD Flashcards
What are causes of GORD?
- physiological
- lifestyle
- hiatus hernia
- genetic inheritance of lower angle of oesophageal sphincter
- oesophagitis
- cancerous tumours/abdominal masses
- Obesity/tight clothes/large meals (raised intraabdominal pressure)
- smoking
- excess alcohol/coffee
- stress
What are the symptoms of GORD?
- heartburn
- acid regurgitation/acid taste in mouth/enamel damage
- excess salivation (water brash)
- dysphagia
- nocturnal asthma/chronic cough
- retrosternal/epigastric pain
- bloating
- hoarse voice
- pain on swallowing
What is the treatment of GORD in under 55s?
Acid neutralisation/PPIs/lifestyle alterations
Unless ALARMS symptoms present - send for endoscopy
What are the ALARMS symptoms of GI malignancy?
Anorexia, loss of weight, anaemia, rapid onset, melena, swallowing difficulty
What is the investigation of GORD in over 55s?
Send for endoscopy and do 24h pH monitoring
What is a surgical management option for GORD?
Laparoscopic fundoplication (ties fundus of stomach around lower oesophagus to narrow sphincter)
What is triple therapy for eradication of H. pylori? (answer with an without penicillin allergy)
Without allergy:
PPI + 2 antibiotics (amoxicillin + clarithromycin/metronidazole)
With allergy:
PPI + 2 antibiotics (clarithromycin + metronidazole)
What is Barretts oesophagus?
squamous –> columnar in oesophagus, symptoms improve but is a premalignant condition
Patients monitored for adenocarcinoma by regular endoscopy
What are some differential diagnosis for the symptoms associated with GORD?
Oesophagitis, NSAID over-use, peptic ulcer, malignancy, oesophageal spasm, heart pain
