GORD Flashcards
1
Q
Predisposing factors for GORD?
A
- obesity
- smoking
- alcohol
- large, late meals
2
Q
Common associated conditions?
A
- sliding hiatus hernia
- pyloric stenosis
- pregnancy
3
Q
Uncommon associated conditions?
A
- diabetic neuropathy
- scleroderma
4
Q
What mechanisms may be behind GORD?
A
- raised intra-abdominal pressure, e.g. obesity, eating large meals, tight clothing, pregnancy
- faulty oesophageal sphincter, e.g. pregnancy - due to hormonal smooth muscle relaxation, smoking, fatty meals, hiatus hernia, after surgery for achalasia
- drugs, e.g. tricyclic depressants, anticholinergics which affect the function of the lower oesophageal sphincter
5
Q
What are the typical symptoms of GORD?
A
- heartburn
- acid regurgitation
6
Q
What are the atypical symptoms of GORD?
A
- dysphagia
- globus sensation
- non-cardiac chest pain
- dyspepsia or abdominal pain
7
Q
Some extra-oesophageal GORD features?
A
- hoarseness
- sore throat
- chronic cough
- laryngitis
- polyps on the vocal cords
- dental erosions
8
Q
When should GORD be investigated?
A
- atypical symptoms
- dysphagia
- short duration of symptoms in patient over 55 years
- weight loss
9
Q
How is GORD investigated?
A
- OGD (can exclude carcinoma)
10
Q
What features require URGENT referral for OGD?
A
gastrointestinal bleeding
iron deficiency anaemia
progressive unintentional weight loss
progressive difficulty swallowing
persistent vomiting
epigastric mass on palpation
suspicious barium meal result or other suspicious imaging result
11
Q
What are some complications of GORD?
A
severe erosive oesophagitis
Barrett's oesophagus
oesophageal carcinoma
oesophageal stricture
haematemesis
melaena
iron deficiency anaemia
12
Q
How is GORD managed?
A
- PPIs
