Reflux and Dysmotility Flashcards
What is the causative problem in Gastro-oesophageal Reflux disease (GORD)?
Incompetent Lower Oesophageal Sphincter
What symptoms do patients with GORD experience?
- Heartburn/ Chest pain
- Acid reflux
- Waterbrash (excess salivation)
- Dysphagia/ Odynophagia
- Weight loss
- Hoarseness
- Coughing
How can GORD be investigated?
- Endoscopy
- Ba swallow
- Oesophageal manometry & pH studies
- Nuclear studies
What are the ALARM Symptoms associated with dyspepsia?
Anaemia (Pernicious) Loss of weight Anorexia Recent Onset Melaena/ Haematemesis Swallowing difficulty
What are the potential complications of GORD?
- oesophagitis (inflammation and ulceration)
- Barrett’s oesophagus
- oesophageal cancer (adenocarcinoma)
Oesophageal carcinoma has a good prognosis. TRUE/FALSE?
FALSE
5-10% alive at 5 years
- mostly palliative
What lifestyle modifications can be used to treat GORD?
- Stop smoking
- Lose weight if obese
- Prop up headboard of bed
What drugs can be given to combat GORD?
- Antacids (for symptom relief)
- PPI
- H2 Receptor antagonists
What surgery can be used to treat GORD? When is it most commonly used?
- Nissen Fundoplication surgery
- Used to heal oesophagitis in youjng patients
- or in those with Severe / unresponsive disease
If a patient’s oesophagus is thought to look dysplastic, how are they managed?
- More frequent surveillance
- Optimise PPI dose
- Endoscopic mucosal resection (EMR)
- Radiofrequency abalation(HALO)
- Argon
What is meant by gastroparesis?
- Delayed gastric emptying
- BUT No physical obstruction
What are the main symptoms of gastroparesis?
- Feeling of fullness
- Nausea
- Vomiting
- Weight loss
- Upper abdominal pain
What can cause gastroparesis?
- Idiopathic
- Diabetes mellitus
- Cannabis
- Medication e.g. opiates, anticholinergics
- Systemic diseases e.g. systemic sclerosis
What test is used to identify gastroparesis?
Gastric emptying studies
How is gastroparesis treated?
- Removal of precipitating factors e.g. drugs
- Liquid / sloppy diet
- Eat little and often
- Pro-motility agents
- Gastric pacemaker
