GORD Flashcards

1
Q

GORD

A

Acid from stomach refluxes through lower oesophageal sphincter

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2
Q

Presentation

A

Heartburn

Acid regurgitation

Retrosternal or epigastric pain

Bloating

Nocturnal cough

Hoarse voice

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3
Q

Referral for endoscopy

A

2 week wait if suspicious of cancer

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4
Q

Red flag features

A

Dysphagia at any age

Aged over 55

Weight loss

Upper abdo pain/ reflux

Treatment resistant dyspepsia

Nausea and vomiting

Low haemoglobin

Raised platelet count

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5
Q

Lifestyle advice

A

Reduce tea, coffee and alcohol

Weight loss

Avoid smoking

Smaller, lighter meals

Avoid heavy meals before bed time

Stay upright after meals rather than lying flat

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6
Q

Treatment of endoscopically proven oesophagitis

A

Full dose PPI for 1-2 months

If response then low dose treatment as required

If no response then double-dose PPI for 1 month

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7
Q

Endoscopically negative reflux disease management

A

Full dose PPI for 1 month

If response then low dose treatment, possibly PRN

If no response then H2RA or prokinetic for one month

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8
Q

Acid neutralising medications

A

Gavison

Rennie

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9
Q

Ranitidine

A

H2 receptor antagonist

Reduces stomach acid

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10
Q

H.pylori

A

Gram negative aerobic bacteria

Damages epithelial lining of stomach resulting in gastritis, ulcers and increased risk of cancer

Produces ammonia

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11
Q

H.pylori tests

A

For anyone with dyspepsia

Need 2 weeks without using PPI before test

Urea breath test (radiolabelled carbon 13)

Stool antigen test

Rapid urease test during endoscopy

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12
Q

Rapid urease test

A

CLO test

Take small biopsy of stomach mucosa

Urea added to sample

If H.pylori present they produce urease enzymes convert urea to ammonia and give positive result of alkali on pH testing

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13
Q

H.pylori eradication

A

Triple therapy with PPI and 2 antibiotics (amoxicillin and clarithromycin) for 7 days

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14
Q

Barrets oesophagus

A

Acid reflux causes metaplasia from squamous to columnar epithelium

Considered premalignant

Risk factor for adenocarinoma of oesophagus

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