GORD Flashcards
Define GORD
Dyspepsia and heartburn due to weakness in the gastro-oesophageal junction and the reflux of stomach contents into the oesophagus
Name some medical causes of GORD
Hiatus hernia
Pregnancy
Name the drug causes of GORD
Beta Blockers Anticholinergics Calcium channel blockers Oral contraceptive N-SAIDS
Name some lifestyle causes of GORD
Obesity, alcohol, smoking
How do you investigate GORD?
- Mainly clinical- based on how symptoms behave after a 1 month PPI trial
- Endoscopy if any red flags
Name some complications of GORD
- Cancer
- Stricture
- Barrett’s Oesophagus
Define Barrett’s Oesophagus
> 3cm of columnar epithelium visible in the lower part of the oesophagus (intestinal metaplasia)
What usually precedes Barrett’s Oesophagus
GORD
What can Barrett’s Oesophagus lead to
Cancer of the lower 1/3 of the oesophagus (adenocarcinoma)
What is a stricture
Narrowing of the oesophagus
How would you manage dyspepsia if you unsure whether its GORD or not
1- One month of lifestyle changes and drug review
2- Empirical PPI for 2 months if GORD is more likely than an ulcer
3- Test for H.Pylori if still symptomatic
What is the test for H. Pylori
Urea breath test
What do PPIs inhibit
H+/K+/ATP channel
Side effects of PPI
Headaches
C. Diff
Diarrhoea, N+V, Constipation
Low magnesium and sodium
Name an H2 receptor blocker
Ranitidine
