GORD

Question 1

Describe the classical symptoms associated with GORD? (7)

Answer 1

Epigastric pain (heartburn)
Worse at specific times of the day (hunger)
Worse on lying flat/straining/stooping
Acid brash taste in mouth 
Waterbrash
Odynophagia
Nocturnal cough

Question 2

Name the ALARM symptoms for GORD?

Answer 2

Anaemia
Loss of weight
Anorexia
Recent onset
Meleana/haemoptysis
Swallowing difficulties

Question 3

Name four risk factors for duodenal ulcers?

Answer 3

H.Pylori
NSAIDs
Steroids
SSRIs

Question 4

Describe the pain associated with duodenal ulcers (most common)?

Answer 4

Epigastric pain
Often worse BEFORE meals and at night time
Pain eased with eating food

Question 5

Describe gastric ulcers?

Answer 5

Often occur in the elderly

Often occur on the lesser curve - ulcers withing the stomach elsewhere are often malignant

Question 6

Name three risk factors for gastric ulcers?

Answer 6

H.Pylori
Smoking
NSIADs

Question 7

Describe the pain associated with gastric ulcers?

Answer 7

Epigastric pain associated with eating food

Question 8

How would you investigate either a duodenal or a gastric ulcer?

Answer 8

Upper GI endoscopy

Urea breath test (H.Pylori)

Question 9

If GORD is chronic - name three complications that may arise?

Answer 9

Oesophagitis
Oesophageal stricture
Barrett’s oesophagus

Question 10

Name seven causes of GORD?

Answer 10

LOS hypotension
Hiatus hernia
Smoking
Alcohol
Abdominal obesity
Pregnancy 
Asthma

Question 11

Name two investigations to conduct in suspected GORD?

Answer 11

Barium swallow

Upper GI endoscopy

Question 12

Which two types of drugs should be avoided with GORD?

Answer 12

Nitrates
CCB
Both relax the LOS

Question 13

Describe hiatus hernias?

Answer 13

1. Sliding - 80% = LOS incompitent

2. Rolling - 20% = gastro-oesophageal junction remains in the abdomen (bulge of stomach herniates into chest)