GORD Flashcards

1
Q

what is GORD?

A

Gastro‐oesophageal refluxdisease(GORD)

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2
Q

what is the pathophysiology of GORD?

A

Dysfunctional Lower Sphincter.
Gastro‐oesophageal refluxisthemovementofgastric contents into the esophagus. Gastric reflux is a normal thing, however, it becomes pathological when the gastric reflux becomes excessive.

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3
Q

what are the other contributing mechanism the can cause GORD?

A
  • Caffeine, alcohol, chocolate, fats can make reflux worse.
  • Certain medications e.g. beta‐blockers, nitrates, calcium channel blockers.
    Impairedoesophageal peristalsis
    Hiatus hernia
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4
Q

what are the symptoms of GORD?

A
  • Heartburn/chest discomfort — Burning sensation or discomfort over the chest
  • Regurgitation — Food or liquid coming back up into mouth
  • Sour or bitter taste in mouth
  • May be worse soon after eating or lying down (e.g. bed time)
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5
Q

When to be concerned in GORD?

A

If symptoms do not settle with pharmacological treatment or there are alarm symptoms (red flags) patient may require investigation with a gastroscopy

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6
Q

What is a gastroscopy?

A

The procedure is done under sedation.

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7
Q

What are the complications of GORD?

A

Reflux oesophagitis
Peptic stricture
Barrett’s esophagus
Cancer– oesophageal adenocarcinoma

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8
Q

what is Reflux esophageal?

A

Damage to oesophageal mucosa by reflux leading to inflammation, ulceration, and bleeding.

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9
Q

what is peptic strictures?

A

Prolonged inflammation of oesophageal mucosa by reflux can lead to fibrosis and scarring

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10
Q

What is Barrett’s esophagus?

A

Damage to the oesophageal epithelium by chronic acid exposure that leads to Oesophageal epithelium (squamous epithelium) transforms to become like gastric epithelium (columnar epithelium with goblet cells).

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11
Q

what is the precursor of Barrett’s esophagus?

A

oesophageal adenocarcinoma

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12
Q

How does Barrett’s present?

A
High risk of suspicion in:
–	Male, over 50
–	Increased BMI
–	Smoker
–	Chronic GORD, especially poorly controlled
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13
Q

what are the things that can increase the risk of Barrett’s to cancer?

A

Smoking, alcohol, certain dietary food

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14
Q

what are the alarm features in GORD?

A
  • Haematemesis
  • Odynophagia
  • Dysphagia
  • Vomiting
  • Weight loss
  • Not improving with proton pump inhibitor treatment
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