GORD

Question 1

What is Barrett’s oesophagus?

Answer 1

Complication of severe GORD

Part of normal oesophageal squamous epithelium replaced by metaplastic columnar mucosa

Question 2

Aetiology of Barrett’s oesophagus

Answer 2

Usually - long term acid reflux#
More common in men age 50-70
Smoking and central obesity

Question 3

Pathogenesis of Barrett’s oesophagus

Answer 3

Malfunction of lower oesophageal sphincter

Question 4

Complications of of Barrett’s oesophagus

Answer 4

Increased risk of cancer

Cells can develop dysplasia

Question 5

Causes of GORD

Answer 5

Weakening of lower oesophageal sphincter
Obesity - increases pressure on stomach
Gastroparesis - stomach takes long time to dispose of acid, common in diabetics (stomach nerves become damaged)

Question 6

Risk factors for GORD

Answer 6

Obesity
High fat diet
Tobacco, alcohol, coffee, chocolate
Pregnancy
Hiatus hernia
Stress

Question 7

Complications of GORD

Answer 7

Ulcer formation
Oesophageal stricture - scar tissue formation causes narrowing
Barrett’s oesophagus
Oesophageal cancer

Question 8

Non-pharmacology therapy for GORD

Answer 8

Lose weight
Stop smoking
Smaller, more frequent meals
Raise head of your bed

Question 9

How do you detect H. Pylori

Answer 9

Urea breath test
Stool antigen test
Blood test

Question 10

How do you eradicate H. Pylori?

Answer 10

Amoxicillin AND clarithromycin AND metronidazole

BD for 7 days

SEs - N&V, diarrhoea, metallic taste, can affect COCP

Question 11

Pharmacological management of dyspepsia

Answer 11

Antacids
H2 Receptor blockers - ranitidine
PPI - Omeprazole
Prostaglandin analogue - misoprostol