GORD - ix and mx

Question 1

What are ‘ALARM’ symptoms?

Answer 1

1. anaemia
2. loss of weight
3. anorexia
4. recent onset and progressive sx
5. melaena
6. swallowing difficulty

Question 2

3 main imaging/invasive testing for GORD?

Answer 2

1. Chest x ray - shows haitus hernia
2. Barium swallow
3. 24 hour ph testing and manometry

Question 3

When is a OGD (gastroscopy) indicated?

Answer 3

If patient is > 55 or exhibits ALARM symptoms

Question 4

What is the first line medical management of GORD?

Answer 4

1. Antacids - Gaviscon
2. Full dose PPI - Lanzoprozole
   - 1/2 months

Question 5

Second line mx of Gord?

Answer 5

1. Double dose PPI

2. H2 receptor antagonist - Ranitadine

Question 6

Third line mx of GORD?

Answer 6

Nissen fundoplication

• laproscopic surgery to repair haitus hernia
• wraps gastric fundus around oesophagus