GORD

Question 1

Presentation of GORD and red flags?

Answer 1

Dyspepsia- indigestion
Bloating

Red flags:
Dysphagia
Weight loss
Reflux
Pain
Low haemoglobin
Raised platelet count

Refer for 2 week wait for urgent direct access endoscopy if dysphagia

Question 2

Management of GORD?

Answer 2

Lifestyle changes

Full dose PPI for 1-2 months and then lower dose e.g. omeprazole and lasoprazole
If no response- double dose PPI for 1 month

OR histamoine H2 anatgonists- famotidine

Question 3

Surgery for GORD?

Answer 3

Laparoscopic fundoplication- tying the fundus of the stomach around the lower oesophagus to narrow the sphincter

Question 4

Caused by chronic acid reflux into oesophagus? Treatment?

Answer 4

Barrett’s oesophagus- cells in loer oesophagus change from squamous to columnar- called metaplasia

Premalignant condition- sig risk factor to develop into oesophageal adenocarcinoma

Treatment:
* PPIs
* Ablation- destroys cells