Reflux, Barrett's and Dysmotility Flashcards
causes of Gastro-oesophageal reflux disease (GORD)
poor oesophageal clearance
barrier function/visceral sensitivity
incompetent lower oesophageal sphincter
symptoms of GORD
heartburn acid reflux waterbrash dysphagia weight loss chest pain hoarseness coughing odynophagia (painful swallowing)
tests for GORD
endoscopy
Ba swallow
oesophageal manometry and pH studies
nuclear studies
what is dyspepsia
indigestion - discomfort/pain in upper abdomen
those at risk of oesophageal carcinoma
not very common
males (M:F = 4:1)
treatment of oesophageal carcinoma
radiotherapy
surgery
palliative care
management of GORD
symptoms relief healing oesophagitis prevent complications lifestyle medications drug treatment surgery
life modifications in GORD
stop smoking
weight loss
prop up bed head
avoid provoking factors
drug treatment for GORD - symptom relief
antacids
H2 antagonists
describe antacids
symptomatic relief - no healing and does not prevent complications
types of H2 antagonists
cimetidine
ranitidine
describe H2 antagonists - cimetidine
rapid symptom relief
less effective at healing than placebo
describe H2 antagonists - ranitidine
poor in preventing relapse and complications
drug treatment for GORD - healing
proton pump inhibitors
types of proton pump inhibitors
omeprazole
lansoprazole
describe Barrett’s oesophagus
intestinal metaplasia -increased risk of adenocarcinoma
irreversible
management of dysplasia
frequent surveillance optimise proton pump inhibitor dose endoscope mucosal resection radio frequency ablation argon
what is hiatus hernia
part of stomach pushes through into lower chest via weakness in diaphragm
types of hiatus hernia
sliding
paraoesophageal
what is gastroparesis
delayed gastric emptying
no physical obstruction
symptoms of gastroparesis
feeling of fullness nausea vomiting weight loss upper abdominal pain
causes of gastroparesis
idiopathic diabetes mellitus cannabis medication systemic diseases
tests for gastroparesis
gastric emptying studies
management of gastroparesis
removal of precipitating factors (drugs) liquid diet eat little and often promotility agents gastric pacemaker
what is achalasia
lower oesophageal sphincter fails to open up during swallowing leading to a backup of food within oesophagus
