GORD Flashcards
Most likely cause of halitosis? (MCQ)
Pharyngeal pouch
What is Barret’s oesophagus ?
Metaplasia of lower oesophageal mucosa (squam ep replaced with gastric columnar)
What is the biggest risk factor for Barrett’s oesophagus?
GORD
What are the risk factors for Barrett’s oesophagus?
- GORD
- obesity
- M
- smoking
What are the causes of GORD?
Defective LOS, reduced oesophageal motility (achalasia), hiatus hernia
What features are indicative of a clinical diagnosis of GORD?
- dyspepsia
- acid regurgitation
(Atypically: epigastric/chest pain, nausea, bloating, belching, globus, laryngitis, tooth erosion)
What symptoms of GORD would be cause for concern?
- WL, anaemia
- dysphagia
- haematemesis/persistent vomiting
- melaena
What are the risk factors for GORD?
- obesity
- alcohol use
- smoking
- diet (coffee, citrus, spicy, fat)
How is GORD investigated?
- PPI trial
- OGD if red flag/atypical/persistent/relapsing symptoms
- oesophageal manometry
How is GORD managed?
Lifestyle
- WL, dietary changes
- elevation of head of bed at night
- avoid late-night eating
PPI (<40, typical symptoms, no red flags)
- standard-dose 8w course + lifestyle
Antacids (symptomatic relief)
Anti-reflux surgery (refractory)
What are the complications of GORD?
- oesophageal ulcers
- Barrett’s
- oesophageal strictures
- adenocarcinoma of oesophagus
