GORD

Question 1

What is it?

Symptoms?

Complications?

Cause?

Answer 1

Gastro-oesophageal reflux disease is a chronic condition

The main symptoms are upper abdominal pain or discomfort, heartburn, gastric reflux, nausea or vomiting

The long term implications of unmanaged GORD are Barrett’s oesophagus and later oesophageal cancer
It can also causes Strictures, Ulcerations and Haemorrhages

Underdeveloped sphincter (LOS) - from premature birth

Question 2

When to suspect in infants?

Answer 2

GORD should be suspected in infants presenting with regurgitation and one or more of the following:

• Distressed behaviour shown, for example, by excessive crying, crying while feeding, and adopting unusual neck postures.
• Hoarseness and/or chronic cough.
• A single episode of pneumonia.
• Unexplained feeding difficulties.
• Faltering growth.

Question 3

Differentials

Answer 3

Psychological
While Psychological factors can be risk factors for GORD. Anxiety can present as stomach pain and so could be mistaken for GORD

Migraine
Primary symptom is a headache, secondary symptoms can be abdominal pain and nausea. So look for presence of a headache to rule out

Mesenteric Adentitis
Causes temporary stomach pain due to inflamed lymph glands - So palpate mesenteric Lymph

Question 4

Red flags suggestive of a cause other than GORD?

Answer 4

Frequent projectile vomiting 
Bile stained vomit 
Abdominal distension, tenderness or palpable mass
Bulging fontanelle
Blood in vomit or stool