GORD Flashcards
What is the cause of GORD?
Caused by reflux of stomach contents into the oesophagus = irritation
Damage to what cause discomfort in patients with GORD? Explain the pathophysiology?
Damage to the squamous epithelial lining
Where does GORD occur mostly?
At the gastro oesophageal junction
What are the 2 main pathophysiologies that cause GORD?
Relaxation of the lower oesophageal sphincter
In intragastric volume pressure
What is the function of the oesophageal sphincter?
Barrier for food and drink to prevent it going back into the oesophagus
What is the job of parietal cells in the stomach?
Produce HCL to help with digestion of food
What is the function of the ECL cells in the stomach?
Stimulates HCL release into the stomach
Give examples of 3 dietary risk factors for GORD?
Smoking
Alcohol
Obesity
Fatty foods
Give 5 examples of risk factors for GORD?
Obesity Smoking Fatty food Obesity Pregnancy Hiatus hernia
What is a hiatus hernia?
When the top part of the stomach has herniated though a weak part of the diaphragm
How does a hiatus hernia cause GORD?
The herniated stomach applies pressure on the lower oesophageal sphincter which causes pooling of gastric acid
Give 6 symptoms of GORD?
Heart burn Acid brash Dysphasia Cough Laryngitis Sinusitis
How will heart burn present in a patient with GORD?
Worse when losing down
Worse after eating
How might the heart burn be described from a patient suffering from GORD?
Angina like pain
What causes bitter taste in the mouth of a patient suffering from GORD?
Acid regurgitation
What feeling in the throat can be described in a patient suffering from GORD?
Lump in the throat
Why might a patient suffering from GORD suffer from chest infection?
Aspiration of gastric contents into the lungs
What causes morning hoarseness in a patient suffering from GORD?
Gastric acid in the voice box causing it to wear away
What are 3 investigation methods used to investigate GORD?
Endoscopy
24 hour PH monitoring
Barium swallowing
What lifestyle changes are recommended for the treatment of GORD?
Weight loss Stop smoking Avoid alcohol Avoid mint Small regular meals Avoid eating 3hours before bed Reduce caffeine, soft drinks, hot drinks, citrus fruits
Give an example of a PPI that is used to treat GORD?
Omeprazole
What are 3 medications used to treat GORD
PPI
antacids
Pro kinetics
What is the MOA of omeprazole in the treatment for GORD?
Blocks the secretion of HCL
What is a long term risk with use of omeprazole associated with?
Increased risk of bone fractures
What are the MOA of antacids?
Neutralise the HCl
What is the aim of surgery in treatment fro GORD?
Aims to increase resting lower oesophageal sphincter pressure
What are 3 complications associated with GORD?
Oesophagitis
Oesophageal stricture
Barrett’s oesophagigus
What causes the formation of oesophageal stricture in GORD?
Fibrosis which causes luminal constriction and narrowing
What is the pathophysiology of Barrett’s oesophagus?
Replacement of columnar epithelium with squamous epithelium
What is Barrett’s oesophagus associated with increase of?
Adenocarcinoma of the Oesophagus
