GORD Flashcards
What is the normal cell type in the oesophagus?
Sqauamous epithelium
In Barrett’s oesophagus, what is the usual oesophageal cell type replaced by and where would you normally find these cells?
Replaced by columnar epithelium which are normally found in the stomach
What is the presentation of GORD?
Heartburn
Acid regurgitation
Retro sternal or epigastric
Bloating
Nocturnal cough
Hoarse voice
What are the red flag features of GOTD that warrant urgent referral to endoscopy?
Dysphagia at any age
Aged over 55
Weight loss
Upper abdominal pain/reflux
Treatment resistant dyspepsia
Nausea and vomiting
Low Hb
Raised platelet count
What is the lifestyle advice for GORD?
Reduce tea, coffee and alcohol
Lose weight
Avoid smoking
Smaller, lighter meals
Avoid heavy meals before bed
Stay upright after meals
What are the medications used to treat GORD?
H2 receptor antagonists (cimetidine)
PPI’s (omeprazole, lansoprazole)
What is the surgery of choice for GORD?
Laparoscopic fundoplication
What type of bacteria is H. Pylori?
Gram negative aerobe
What are the tests for H.Pylori?
Urea breath test
Stool antigen test
Rapid urease test (during endoscopy)
Who is offered a H. Pylori test and what can affect the test accuracy?
Anyone with dyspepsia
PPI use can affect test accuracy, patient must be off them for 2 weeks before test
How is H.Pylori infection treated and for how long is the treatment period?
Triple therapy
PPI
2 antibiotics (e.g. amoxicillin and clarithromycin) for 7 days
What is Barrett’s oesophagus a risk factor for developing?
Adenocarcinoma of the oesophagus
Barrett’s is a premalignant condition
How are patients with Barrett’s monitored for cancer of the oesophagus?
Endoscopy
How is Barrett’s treated?
PPI’s
Ablation treatment during endoscopy (only recommended in patients with dysplasia to prevent progression to cancer)
What is the progression stages from Barrett’s to adenocarcinoma (4 stages)
Barrett’s with no dysplasia
Low grade dysplasia
High grade dysplasia
Adenocarcinoma
