GORD* Flashcards
What is GORD
The reflux of gastric content into the oesophagus caused by a dysfunctional LOS
What are the causes of GORD
Lower oesophageal HTN (Preg and Obesity) Oesophageal dysmotility Gastric acid hyper secretion Scleroderma Sliding Hiatus hernia
What are the presentations of GORD
Dyspepsia( heartburn) worse eating food
Nocturnal asthma and Chronic cough
Dysphagia? bad sign
WORSE LAYING DOWN
What are the alarm symptoms of GORD
DO OGD-OESOPHAGOGASTRODUODENOSCOPY
Weight loss Anaemia Dysphagia Melaena Haeamatemesis
What are the investigations of GORD
Trial of PPI
OGD if alarm symptoms or recurrence
Oesophageal manometry
What is the management of GORD
Lifestyle change (weight loss, eating routine, extra pillows) PPI therapy <40 with no alarm symptoms (Give H2 antagonist as adjunct) Antacids (symptom relief) Anti-reflux
What are the MAIN complications of GORD
Barret’s oesophagus -> Adenocarcinoma
Oesophageal stricture
What is the surgical intervention of GORD
Nissen Fundoplication
-Wrap stomach fundus around LO to tighten the sphincter
What are oesophageal strictures and how are they treated
Worsening Dysphagia
Tx = Oesophageal dilation and PPI
What is Barrets
Associated w/ Hiatus hernia
Squamous to Columnar metaplasia (Increase risk of adenocarcinoma)
Dx w/ Biopsy
What is Mallory Weiss Tear
Lower Oesophageal mucosal tear due to increase intrabdo pressure
What is the typical presentation of MWT
Young Px retching after night out leading to HAEMATEMESIS
What are the RF for MWT
Alcohol
Chronic cough
Bolemia
Hyperemesis Gravidorum (Severe morning sickness during Pregnancy)
What is Hyperemesis Gravidorum in MWT
Severe N+V causing weight loss and dehydration
What is crucial to rule out when diagnosing MWT
Oesophageal varices rupture
-Presnets with Haematemesis, Liver disease and Pulmonary HTN
