GORD Flashcards
What are the main causes of GORD?
Pregnancy
Obesity
Gastritis
Hiatus hernia
Achalasia
H. Pylori
A big meal
What is GORD?
Dyspepsia from acid/bile damaging the lower oesophageal mucosa
What are the symptoms of GORD?
Heartburn
Water brash
Cough
Inability to get to sleep
- Worse on lying down
Odynophagia
What is water brash?
Excessive salivation
What causes odynophagia with GORD?
Oesophagitis
Complications of GORD?
Oesophagitis
BARRETT’S OESOPHAGUS
- Therefore oesophageal adenocarcinoma too
Ulcers
DDx?
Corrosive oesophagitis
Infection
DU and GU
Gastric cancer
Tests?
Usually not required in isolated cases
Endoscopy (follow protocol)
24hr oesophageal pH monitoring +/- oesophageal manometry
What is the indications for endoscopy in GORD?
> 55yrs
Symptoms >4weeks
ALARMS
Dysphagia
What treatment methods can be used?
Lifestyle changes
Pharma
Surgery
What lifestyle changes can be encouraged?
LOSE WEIGHT
Smoking cessation
Small regular meals
Avoid NSIADs
Pharma treatment in first 4 weeks?
Antacids
- Alginates
- Magnesium trisillicate
What pharma treatment should be employed if oesophagitis is confirmed?
PPI
- Lansoprazole
- Omeprazole
When is surgery indicated?
Severe symptoms
No improvement with treatment AND evidence of pH monitoring
What operation can be done?
Nissen fundoplication
