Week 4- Upper GI conditions - GORD, functional dyspepsia

Question 1

what is GORD AND CAUSED BY?

Answer 1

-Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus (gullet
• Caused by gastric juice and occasionally
duodenal contents in oesophagus
-Thought to be Defective Lower Oesophageal Sphincter may be most important abnormality

Question 2

what are the factors lowering the pressure of the lower oesophageal sphincter (LOS) causing it to relax ?

Answer 2

• Dietary factors
• fat, chocolate, caffeine, alcohol
• Cigarette smoking
• Endocrine factors
• high levels of oestrogen and
progesterone (pregnant )
• Drugs
-gives burning sensation

Question 3

what is the hiatus hernia?

Answer 3

• Part of the stomach is pushed up
through diaphragm
- prevents LOS from closing
- allowing stomach contents to escape
• Hiatus Hernia very prevalent
• 30-50% of population
• Majority of patients asymptomatic
• May present as GORD

Question 4

what kind of drugs can lower the LOS PRESSURE?

Answer 4

• Anticholinergics
• Beta-2 agonists
• Calcium channel blockers
• Diazepam
• Nitrates
• Alcohol
• Progesterones
• Oral contraceptives
• Theophylline

Question 5

what kind of drugs can cause oephageal ulcertation?

Answer 5

 NSAIDS  Bisphosphonates  Clindamycin  Clotrimoxazole  Doxycycline  Potassium  Theophylline  Tetracycline
 Antibiotics responsible for 50%
of drug induced Oesophagitis  Esp. Clindamycin in capsule form

Question 6

how is the motility of the oephagus affected by GORD?

Answer 6

-its abnormal
-Gastric emptying delayed in 40% patients with
GORD ( food staying in stomach longer can lead to going back up)

Question 7

what are some symptoms of GORD?

Answer 7

May also suffer dysphagia or odynophagia (pain on

swallowing)

Question 8

What are some complications of GORD?

Answer 8

Barett’s oesophagus -risk factor of cancer when the lining of the oesphagus so they resemble to intetsine

Question 9

HOW IS gord diagnosed?

Answer 9

through an endoscopy

Question 10

what is functional dyspepsia?

Answer 10

• dyspepsia which has been investigate but not organic disease detected
• possibly a hypersensitvity of gastric acid

Question 11

what are the four groups of functional dyspepsia?

Answer 11

• Ulcer like
• Dysmotility like
• Reflux like
• Non-specific

Question 12

what are the aims for treatment of functioanl dyspepsia?

Answer 12

• Eradicate H.P if present
• Neutralize acid or prevent acid production (symptomatic
relief)
• Periodic monitoring

Question 13

if a patient has heartburn immediately after food or with fooD and has an organic disease then it is ?

Answer 13

GORD

Question 14

if a patient has heartburn immediately after food or with food and has no organic disease then it is ?

Answer 14

functional disease

Question 15

if a patient has epigastric pain(stomach) immediately after food or with food and has an organic disease then it is?

Answer 15

Gastritis or Gastric

ulcer

Question 16

if a patient has epigastric pain(stomach) immediately after food or with food and has no organic disease then it is?

Answer 16

functional dyspepsia

Question 17

if a patient has epigastric pain(stomach) Pain between
meals or at night
or pain relieved by
eating and has no organic disease then it is?

Answer 17

function dypsepsia

Question 18

if a patient has epigastric pain(stomach) Pain between
meals or at night
or pain relieved by
eating and has an organic disease then it is?

Answer 18

Gastritis or Duodenal

ulcer