GORD

Question 1

Definition

Answer 1

When reflux of stomach contents (acid ± bile) causes troublesome symptoms (≥2 heartburn episodes/wk) and/or complications

Question 2

prolonged reflux may lead to what?

Answer 2

oesophagitis
benign oesophageal stricture
Barret’s oesophagus

Question 3

causes

Answer 3

LOS hypotension
hiatus hernia
abd obesity
gastric acid hyper secretion
loss of oesophageal peristaltic function
systemic sclerosis

Question 4

What’s Barrett’s oesophagus

Answer 4

metaplasia of distal oesophageal epithelium from squamous to columnar

(appears velvety)

Question 5

clinical features

Answer 5

heartburn
regurgitation + odynophagia (painful swallowing)

cough + nocturnal asthma

Question 6

Dx tests

Answer 6

endoscopy

barium swallow: may show hiatus hernia

24hr oesophageal pH monitory + manometry

Question 7

manometry

Answer 7

measures the function of the LOS and muscles of the oesophagus

thin, pressure sensitive tube passed down oesophagus and into stomach

Question 8

encourage

Answer 8

raising the bed head ± weight loss, stop smoking, small, regular meals

Question 9

avoid

Answer 9

hot drinks, alcohol, citrus fruits, tomatoes, onions etc

eating

Question 10

drug treatment

Answer 10

antacids - magnesium tricilicate mixture

alginates - Gaviscon Advance

PPI for oesophagitis - lansoprazole

Question 11

surgery

Answer 11

to increase resting LOS pressure