GORD PBL Flashcards
What are the symptoms of acid reflux?
Burning sensation behind sternum/epigastric region
Can radiate to throat
Pressure on chest
Squeezing or stabbing in chest
Bitter taste in mouth
When is acid reflux more likely to happen?
After spicy or big meal
After drinking alcohol
During pregnancy
Lying down after eating
What is the mechanism of acid reflux?
Lower oesophageal sphincter relaxes/weakens
Allows stomach acid to reach oesophagus
Acid inflames lining of oesophagus
What is the lower oesophageal sphincter? Function?
T11 level
Physiologic sphincter maintained by:
acute angle, intra-abdominal pressure compresses oes, mucosal folds occludes, right crus of diaphragm
Prevents reflux
What are side effects of acid reflux?
Shortness of breath (dyspnea) - acid from oesophagus enters lungs = swelling of airways
-> asthma, aspiration pneumonia
Tooth erosion
Belching
Name the risk factors for GORD?
Stress
Obesity
Smoking
Calcium channel blockers
How is stress a risk factor for GORD?
Can cause irregular peristalsis in oes
Can cause increased stomach acid
How is obesity a risk factor for GORD?
Fat on the stomach causes pressure on stomach
Can cause hiatal hernia
Increases oestrogen -> relaxes LOS
How is smoking a risk factor for GORD?
Reduces LOS pressure
Reduces saliva production with bicarbonate - buffers acid in oes
What is GORD?
Gastroesophageal acid reflux disease
Chronic acid reflux
What is the development from GORD to Barrett’s oesophagus?
Metaplasia of oesophageal epithelia from squamous to columnar
Takes 10 years of GORD
What is short segment vs long segment Barrett’s oesophagus?
Short segment - up to 3cm up
Long segment - more than 3 cm up
How many people develop Barrett’s oesophagus?
10-15% GORD patients will develop Barrett’s
What measures can be done to manage GORD?
Lose weight
Elevate head whilst sleeping
Quit smoking
Eat little and frequently
Reduce alcohol
Don’t eat 3-4 hours before sleep
What types of medication can be taken to manage GORD?
Antacids
H2 blockers
Proton pump inhibitors
