GORD and Dysmotility Flashcards
What causes GORD?
Imcompetent lower oespophageal sphincter
Poor oesophageal clearance
Barrier function/ visceral sensitivty
What are symtpoms of GORD?
Heartburn Acid reflux Waterbrash Dysphagia Odynophagia Weight loss Chest pain Hoarseness Coughing
How can GORD be investigated?
Endoscopy
Ba swallow
Oesophageal manometry and pH studies
Nuclear studies
What can cause dyspepsia?
Dysphagia Wt loss Anaemia Vomiting F/G of UGI cancer Barrett's Pernicious anaemia PUD surgery
What is the pathogenesis of adenocarcionma?
Normal then oesophagitis then barrett’s then adenocarcinoma
How is GORD managed?
Symptom relief
Healing oesophagitis
Prevent complications
What are lifestyle modifications that can be done to help with GORD?
Stop smoking
Lose weight
Prop up the bed head
Avoid provoking factors
What are antacids used for?
Symptomatic relief
Majority of reflux patients
Doesn’t heal or prevent complications
What are examples of H2 antagonists?
Cimetidine - rapid symtom relief
Ranitide - tolerance after 4 weeks, poor in preventing replase and complications
What is nissen fundoplication?
Controls symptoms
Heals oeophagitis in young patients and in severe/unresponsive disease
What is barrett’s oesophagus?
Intestinal metaplasia that is irreversible
Increased risk of adenocarcionma
How is dysplasia managed?
More frequent surveillance, optomise PPI dose, endoscopic mucosal resection, radiofreqeuncy ablation and argon
What is a hiatus herina?
Sliding of the stomach and oesophagus through the diaphragm
What is gastroparesis?
Delayed gastric emptying with no physical obstruction
What are symptoms of gastroparesis?
Feeling of fullness Nausea Vomiting Weight loss Upper abdominal pain
