GORD Flashcards
What is GORD?
Reflux of the gastric contents back into the oesophagus, through the lower oesophageal sphincter
What is the epithelial lining of the oesophagus?
Squamous epithelium (which is more sensitive than columnar epithelium to the effects of stomach acid)
What are common triggers for GORD?
Greasy/spicy foods
Coffee/tea
NSAIDs
Stress
Smoking
Obesity
Hiatus hernia
What is the pathophysiology of GORD?
Increased sphincter relaxation
Raised intragastric pressure
Reduced sphincter tone
Oesophageal dysmotility
What are the risk factors for GORD?
Age
Family history
Obesity
Pregnancy
Hiatus hernia
Smoking and alcohol
Fatty foods
What is the presentation of GORD?
Heartburn
Acid regurgitation
Retrosternal or epigastric pain
Bloating
Nocturnal cough
Hoarse voice
What are the red flag symptoms of GORD?
Dysphagia
Weight loss
Upper abdominal pain
Reflux
Treatment-resistant dyspepsia
Nausea and vomiting
Upper abdominal mass
Low haemoglobin
Raised platelets
What investigations are used in the diagnosis of GORD?
H. pylori testing
Endoscopy - normal
24 hour pH study
Oeseophageal manometry
What is the first line management of GORD?
Lifestyle changes
- Weight loss
- Avoidance of triggers
- Smoking cessation
- Eating smaller meals, not eating before bed
Medication review
PPI - full dose PPI for 1-2 months
What is the second line management of GORD?
Histamine H2-receptor antagonists
Surgery - laparoscopic fundoplication
What are the complications of GORD?
Barrett’s oesophagus
Oesophageal ulceration
Oesophageal stricture
Anaemia
Aspiration pneumonia
Dental problems
