GORD

Question 1

Gastro-oesophageal reflux disease is associated with which symptoms?

Answer 1

Heartburn, acid regurgitation, and dysphagia, Oesophageal inflammation

Question 2

which condition is GORD associated with?

Answer 2

Asthma

Question 3

outline the drugs used for the management of mild symptoms of GORD

Answer 3

1) Antacids and alginates- “Raft” reduce reflux and protect the oesophageal mucosa
2) H2-receptor antagonists- reduces antacid consumption
3) PPIs provide more effective relief of symptoms than H2-receptor antagonist

Question 4

1) How should severe symptoms of GORD be managed?

2) when should a patient be reassessed?

Answer 4

1) Initial management involves the use of a PPI

2) Reassessed if symptoms persist despite treatment for 4–6 weeks

Question 5

when symptoms are under control, how is the dose of PPI adjusted?

Answer 5

Treatment is titrated down to a level which maintains remission (e.g. reducing PPI dose or give intermittently, or switch to H2-receptor antagonist)

Question 6

How is GORD managed in pregnancy if dietary and lifestyle changes fail

Answer 6

1) An antacid or an alginate can be used
2) If ineffective, ranitidine can be tried
3) Omeprazole is reserved for women with severe or complicated reflux disease

Question 7

GORD is common in infancy and most symptoms resolve without treatment between 12 and 18 months of age. How should mild or moderate reflux be managed in infants?

Answer 7

1) Changing the frequency and volume of feed
2) Feed thickener or thickened formula feed can be used (with advice of a dietitian)
3) If necessary, alginate-containing preparation can be used instead of thickened feeds