GORD

Question 1

Definition

Answer 1

Clinical diagnosis resulting from the reflux of gastric contents into the oesophagus

Question 2

Risk Factors

Answer 2

Obesity
Alcohol use
Smoking
Specific foods - coffee, spicy, fatty, acidic
Hiatus hernia (LOS herniates into the thorax)

Question 3

Presentation

Answer 3

Dyspepsia (heart burn)
Acid regurgitation sensation
Epigastric pain
Nausea
Bloating
Belching
Tooth erosion

Question 4

Pathophysiology

Answer 4

The lower oesophageal sphincter is defected which enables reflux of gastric contents into oesophagus

Question 5

Investigations

Answer 5

• trial of PPIs
• an oesophagogstroduodenoscopy if alarming features

Question 6

What are some red flag symptoms that suggest a complication

Answer 6

Weight loss
Anameia
Dysphagia
Haematemesis
Malaena
Persistant vomiting

Question 7

Management

Answer 7

Lifestyle - weight loss, diet
PPIs
H2 receptor antagonist

If no better, fundoplication - fundus of stomach is wrapped around LOS to secure it

Question 8

What is the mechanism of action of H2 antagonists and name 1

Answer 8

Ranitidine
Inhibits H2 receptors as histamine activates parietal cells

Question 9

Name 2 PPIs

Answer 9

Lanzoprazole
Omeprazole

Question 10

Complications

Answer 10

Oesophageal ulcer
Barretts oesophagus
Oesophageal haemorrhage
Oesophageal structure
Adenocarcinoma of the oesophagus.