GORD Flashcards
What is GORD?
where acid from the stomach flows through the lower oesophageal sphincter and into the oesophagus where it irritates the lining and causes heartburn symptoms
What is the cardinal clinical presentation of GORD?
heartburn
What cells line the oesophagus?
squamous epithelium
What cells line the stomach?
columnar epithelium
Describe the pathophysiology of GORD:
transient lower oesophageal sphincter relaxations (which occur as part of normal physiology) occur more frequently causing gastric flow back into the oesophagus
Give 9 risk factors for GORD:
1) pregnancy
2) obesity
3) cigarette smoking
4) alcohol
5) coffee intake
6) large or fatty meals
7) spicy food intake
8) hiatus hernias
9) stress
Give 3 drugs that predispose to GORD:
1) antimuscarinics
2) calcium-channel blockers
3) nitrates
Give 6 clinical features of GORD:
1) heartburn (which is worse when bending, stooping or lying down)
2) acid regurgitation
3) bloating
4) nocturnal cough
5) hoarse voice
6) retrosternal/epigastric pain
True or false: GORD is mostly a clinical diagnosis that doesn’t require further investigation
true
Name two investigations for GORD:
1) endoscopy
2) intraluminal monitoring
How can endoscopy help diagnose GORD?
it can visualise visible breaks in the oesophagus mucosa, indicating oesophagitis
Describe how intraluminal monitoring can be used to investigate GORD:
a nasogastric tube with a pH probe is passed down the oesophagus for 24 hours
What action is taken if a GORD patient has any red flags, particularly dysphagia?
2 week wait referral for direct access endoscopy
What is the key red flag in GORD?
dysphagia
Name 8 red flags associated with GORD:
1) dysphagia
2) weight loss
3) abdominal mass
4) resistant to treatment
5) upper abdominal pain
6) nausea and vomiting
7) raised platelet count
8) anaemia
Name 3 lifestyle changes used to manage GORD:
1) weight loss
2) raising the head of the bed at night
3) reduction in alcohol and coffee consumption