GORD Flashcards
GORD is a general term describing range of situations - reflux with/without oesophagitis. True or false?
true
what is it
inflammation of oesophagus due to reflux of acid from stomach
what is the squamous cell changes in response to the acid
basal zone hyperplasia and elongation of papillae as cell type changes to deal with acid
what causes it
incompetent LOS
impaired oesophageal clearance/motility
defective mucosal barrier
what are risk factors
pregnancy obesity hiatus hernia large (fatty meals), alcohol Ca2+ blockers and nitrates
what are symptoms
heartburn, aggravated by lying down regurg of food and acid dysphagia odynophagia chest pain nocturnal cough waterbrash (excessive salivation) weight loss
how is it diagnosed
endoscopy - if Barrett’s then GORD confirmed
manometry/pH studies if endoscopy normal
barium swallow
rarely nuclear imaging
how is it treated
PPI (omeprazole)
antacids (gaviscon - bases)
H2 receptor antagonists (ranitidine, cimetidine - rapid)
Endoscopic fundoplication to repair LOS if young and unresponsive to meds
what is the complications
ulceration, bleeding
stricture formation due to scarring
barretts oesophagus
oesophageal cancer
