Reflux disease, Barretts & dysmobility of oesophagus & stomach Flashcards
what is GORD?
gastro-oesophageal reflux disorder
when does GORD occur?
= incompetents lower oesophageal sphincter
Causing;
- poor oesophagus clearance
- barrier function/visceral sensitivity
what are symptoms of GORD?
- heartburn
- acid reflux
- water brash
- dysphagia
- odynophagia (pain swallowing)
- weight loss
- chest pain
- hoarseness
- coughing
what 4 things could you use to investigate GORD?
1) endoscopy
2) barium swallow
3) oesophageal manometry & pH studies
4) nuclear studies
what are 8 red flags?
1) dysphagia
2) weight loss
3) anaemia
4) vomiting
5) F/H UGI cancer
6) Barrett’s
7) pernicious anaemia
8) previous ulcer disease > 20years
who is at greater risk of getting oesophageal carcinoma?
Males > females
what are 3 treatments of oesophageal carcinoma?
1) radiotherapy
2) surgery
3) palliation
what is the pathogenesis of adenocarcinoma?
- normal
- oesophagiitiis (reversible)
- barrett’s (irreversible)
- adenocarcinoma (too late)
how would you treat GORD?
1) symptom relief
2) heal oesophagitis
3) prevents complications
what are 4 lifestyle modifications?
- stop smoking
- lose weight if obese
- prop up bed head
- avoid provoking factors
why are anti-acids used fro?
= symptomatic relief
NO BENEFIT:
= of healing or preventing complications
give 2 examples of H2 antagonists?
1) cimetidine
2) ranitidine
describe the role of cimetidine and ranitidine?
Cimetidine
= rapid symptom relief
- less effective a healing than placebo
Ranitidine
= tolerance after 4/52 therapy
= poor in preventing relapse and complications
what are 2 examples of proton pump inhibitors?
1) omeprazole
2) lansoprazole
when are proton pumps used?
= symptom relief
= healing (grade 1-II oesophagitis)
