GORD

Question 1

What is barrets oesophagus?

Answer 1

metaplasia of the lower oesophageal mucosa, with the usual squamous epithelium being replaced by columnar epithelium.

Question 2

what is the risk of oesophageal cancer with Barrett oesophagus?

Answer 2

oesophageal adenocarcinoma, estimated at 50-100 fold.

Question 3

risk factors for Barretts?

Answer 3

gastro-oesophageal reflux disease (GORD) is the single strongest risk factor
male gender (7:1 ratio)
smoking
central obesity

Question 4

how often is endoscopic surveillance for barrels oesophagus?

Answer 4

for patients with metaplasia (but not dysplasia) endoscopy is recommended every 3-5 years

Question 5

what is the management for oesophageal dysplasia?

Answer 5

endoscopic mucosal resection

radiofrequency ablation

Question 6

what are the different tests available for H pylori?

Answer 6

Urea breath test using radiolabelled carbon 13
Stool antigen test
Rapid urease test can be performed during endoscopy (Clo test).

Question 7

what is the electrolyte imbalance caused by omeprazole?

Answer 7

hyponatraemia

Question 8

which test is preferred for post H.pylori eradication therapy?

Answer 8

urea breath test

Question 9

what are the side effects of omeprazole?

Answer 9

hyponatraemia, hypomagnasaemia
osteoporosis → increased risk of fractures
microscopic colitis
increased risk of Clostridium difficile infections

Question 10

when should urea breath test for H pylori not be preformed?

Answer 10

4 weeks of treatment with an antibacterial or within 2 weeks of an antisecretory drug (e.g. a proton pump inhibitor)