GORD Flashcards
What is Gastrointestinal-Oesophageal Reflux Disease (GORD)?
Leakage of gastric contents into the distal oesophagus
What are the main risks associated with GORD?
- Alcohol
- Cigarettes
- Obesity
- Pregnancy
What medical condition involves the stomach and lower oesophagus moving through the oesophageal hiatus?
Hiatal hernia
What is Zollinger-Ellison syndrome?
Gastroma tumour secreting gastric acid
What factors can exacerbate GORD symptoms?
- Greasy/spicy food
- Coffee
- Tea
- Alcohol
- NSAIDs
- Stress
What are common presentations of GORD?
- Dyspepsia (heartburn)
- Acid regurgitation
- Retrosternal/epigastric pain
- Nocturnal cough
- Hoarse voice
- Dysphagia
- Odynophagia
What are the red flags associated with GORD?
- Dysphagia
- Age over 55
What is the pathogenesis of GORD?
Gastric acid injures the lining squamous epithelium leading to inflammation and hyperplasia
What is the gold standard for diagnosing GORD?
Endoscopy, with 24-hour monitoring in the lower oesophagus
Stop PPI’s 2 weeks before
What lifestyle changes are recommended as the first line of treatment for GORD?
- Weight loss
- Dietary modifications
- Elevating the head during sleep
- Smoking cessation
- Medication review
What is the first-line drug treatment for GORD?
Proton Pump Inhibitors (PPIs) for 4 weeks
Invetigate for H.pylori, if present start triple therapy
What should be done if oesophagitis is diagnosed upon endoscopy?
Full dose PPI for 2 months
What is Nissan Fundoplication?
Surgery where the gastric fungus is wrapped around the lower oesophagus to reduce acid reflux
What are the complicationsof GORD?
- Oesophageal ulceration
- Oesophagitis
- Haematemesis and melena
- Oesophageal stricture
- Barrett oesophagus –> oesophageal cancer
What is Barrett Oesophagus?
Metaplasia of the lower oesophagus epithelium changing from squamous to intestinal columnar epithelium
What are the causes/risks of Barrett Oesophagus?
- GORD
- Male
- Smoking
- Obesity
What is the recommended management for Barrett Oesophagus with metaplasia?
- High-dose proton pump inhibitor
- Endoscopic surveillance every 3-5 years
If dysplasia is diagnosed on routine screening in Barrets Metaplasia what should be done
Ofer endoscopic intervention
Options include: Radiofrequency ablation: preferred first-line treatment, particularly for low-grade dysplasia OR endoscopic mucosal resection
What is the preferred first-line treatment for dysplasia in Barrett Oesophagus?
Radiofrequency ablation
Fill in the blank: Metaplasia refers to changes to all types of cells, while _______ refers to the presence of abnormal cells.
dysplasia
