GORD Flashcards
What does GORD stand for
Gastro-oesophageal reflux disease
definition
prolonged or recurrent reflux of gastric contents into the oesophagus
clinical presentation
heart burn worse laying down and after meals odynophagia- pain whilst swallowing regurgitation hoarse throat wheezing acidic taste in mouth
what does LOS stand for
lower oesophageal sphincter
pathophysiology
tone of LOS causes an increase in the relaxation of the sphincter allows the reflux of gastric acid, pepsin, bile and duodenal contents into the oesophagus
LOS relaxes independently of a swallow allowing gastric acid to flow back into the oesophagus
risk factors
obesity male inc abdominal pressure- pregnancy/obesisty smoking hiatus hernia
aetiology
obesity hiatus hernia - cant close properly LOS hypotension overeating systemic sclerosis loss of oesophageal peristaltic function
signs of GORD
nocturnal asthma - due to aspiration of gastric contents into lungs
differential diagnosis
coronary artery disease
biliary colic
peptic ulcer
malignancy
investigations
usually diagnosed on clinical findings as long as there arent any concerning symptoms suggesting otherwise ie weight loss
oesophago-gasto-duodenoscopy - endoscopy - can show hiatus hernia or oesophagitis
barium swallow
management
lifestyle changes- weight loss stop smoking etc
antacids- gaviscon
PPI- lansoprazole/ omeprazole - inhibit hydrogen release
H2 receptor antagonist - cimetidine - blocks histamine receptors on parietal cells
surgery
complications
barrets oesophagus - epithelium undergoes metaplasia changes from squamous to columnar (w globlet)- can progress to cancer
peptic structure- cause narrowing of oesophagus
