GORD Flashcards
What is GORD?
Reflux of stomach acid back through the LOS, iritating the oesophageal lining.
Why is the oesophagus affected by the acid and not the stomach?
Oesophagus has a squamous epithelial lining.
Stomach has columnar epithelial lining and bicarbonate-rich mucus.
What causes the reflux to occur?
Transient relaxation of the LOS
How does GORD present?
Burning retrosternal chest pain:
- Worse when flat
- Worse with certain foods
- Hoarse voice
- Acid brash (acid in throat, salivate more- water brash)
- Cough
When should you do an OGD in GORD?
Concerning Features/Red Flags
- Dysphagia
- Age 55+
- Weight Loss
- Bleeds
When should you admit urgently?
Bleeds:
- Melaena
- Coffee ground
- Low Hb
How is GORD conservatively managed?
- Reduce caffeine and citrus
- Smaller, lighter meals
- Don’t eat before bed
- Weight loss
What OTC medication should be tried first?
- Gaviscon
- Rennie
How do Gaviscon and Rennie work?
Antacids
What drug should be prescribed first hand?
PPIs
What else may be prescribed for GORD?
Ranitidine
How does Ranitidine work?
H2 antagonist
- Blocks parietal cell stimulation
What surgery is used for GORD?
Fundoplication
How does fundoplication work?
Narrows the LOS
What can predispose to GORD and gastritis?
H.pylori