GORD Flashcards

1
Q
A
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2
Q

define GORD

A

Gastro- oesophageal reflux disease, prolonged or recurrent reflux of the gastric contents into the oesophagus

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3
Q

describe the pathophysiology behind GORD

A
  1. Reduced tone of LOS- Lower oesophageal sphincter- decreases pressure
  2. increase in transient LOS relaxation
  3. increased mucosal sensitivity to gastric acid
  4. more potential for free up passage of acid
  5. reflux of gastric acid, pepsin, bile and duodenal contents back into oesophagus
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4
Q

epidemiology in GORD

A

more common in men

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5
Q

what are the symptoms of GORD?

A
  1. heartburn
    - retrosternal burning chest pain
    - worse when lying down
  2. odynophagia
    - pain when swallowing
  3. chronic cough + nocturnal asthma
  4. regurgitation
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6
Q

what are complcations of GORD?

A
  • Barretts oesophagus
  • oesophageal cancer
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7
Q

what are the causes of GORD?

A
  1. increased intraabdo pressure- obesity, pregnant
  2. hiatal hernia- mostly with sliding, LOS sphincter can’t close propperly
  3. drugs- antimuscarinics
  4. scleroderma- scarred LOS
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8
Q

how is GORD diagnosed?

A
  • If no red flags
  • go straight to treatment
  • if red flags
  • endoscopy- oesophagus or barretts oesophagus
  • oesophageal manometry- measure LOS pressure + monitor gastric acid pH
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9
Q

what are the red flags for GORD?

A

dysphagia
haematomesis
weight loss

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10
Q

what is the treatment for GORD?

A
  1. Lifestyle changes ( conservative)
  2. antacids
  3. protein pump inhibitors
  4. H2 receptor antagonist
  5. last resort: surgical tightening of LOS
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11
Q

what is the pathophysiology of Barents oesophagus?

A
  • complication of GORD
  • oesophagus epithelium undergoes metaplasia squamous —> collumnar epithelium with goblet cells
  • always involve hiatal hernia
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12
Q

what is the percentage of GORD patients develop Barrett’s oesophagus?

A

10%

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13
Q

what does barretts oesophagus increase the risk of?

A

adenocarcinomas

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14
Q

what is the epidemiology for barretts oesophagus?

A
  • middle aged Caucasian male with a history of GORD + progressively worsening dysphagia
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15
Q

how do you diagnose barretts oesophagus?

A

biopsy

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