GORD Flashcards
What is GORD?
Stomach contents leaks back from stomach into oesophagus
Which foods aggravate GORD?
- EtOH
- Caffeine
- Spicy/fatty/fried foods
- Tobacco
- Chocolate
- Peppermint
- Citrus fruit juices
Aetiology of GORD?
-Inappropriate transient relaxation of lower oesophageal sphincter.
-Zollinger Ellison syndrome
Contributing fx: delayed oesophageal clearance, delayed gastric emptying, increased intra-abdominal pressure.
What is Zollinger Ellison syndrome?
Gastrin secreting neuroendocrine tumour triggering gastric acid hypersecretion
CFx GORD?
- Heartburn (pyrosis)
- Acid regurgitation
- +/- sour regurgitation, lump in throat (bolus sensation) and frequent belching.
How is GORD diagnosed?
Clinical diagnosis based on Hx and relief following trial of PPI
Indications for gastroscopy?
- Heartburn + red flags (bleeding / weight loss etc)
- No relief post 4-8/52 trial of PPI
- Hx of oesophageal stricture with persistent dysphagia
When is oesophageal manometry indicated?
Pre surgical fundoplication to ensure oesophagus functional (more likely successful in lower oesophageal pressure is diminished)
Mx of GORD?
Lifestyle: -Relief of symptoms through food trigger avoidance -Weight loss -Bed head elevation Rx: PPI Surgical: fundoplication
Complications of GORD?
- Oesophageal stricture
- Ulcer
- Bleeding
- Barrett’s Oesophagus
How may GORD precipitate dysphagia?
Reflux related oesophageal stricture
How is reflux related stricture diagnosed?
Gastroscopy: confirms diagnosis and excludes malignancy; therapeutic stricture dilation
Treatment of reflux related oesophageal stricture?
- Dilate stricture at gastroscopy
- Treat cause: PPI, fundoplication.
Features of GORD on nasa-oesophageal pH monitor?
Check for pH
Alternative to naso-oesphageal pH monitor?
Bravo pH capsule: clipped to side of oesophagus. Measures pH for 48h.
