Gastro-oesophageal reflux disease Flashcards

1
Q

What contributes to GORD?

A

Incompetent Lower Oesophageal Spinchter

Poor oesophageal clearance

Barrier function/ Visceral sensitivity

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2
Q

What are the symptoms of GORD?

A
Heartburn
Acid reflux
Waterbrash
Dysphagia
Odynophagia
Weight loss
Chest pain
Hoarseness
Coughing
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3
Q

What are the investigations of GORD?

A
Endoscopy 
Barium swallow (type of X-ray)
Oesophageal manometry & pH studies
Nuclear studies
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4
Q

What is Dyspepsia?

A

indigestion

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5
Q

What are the alarming symptoms when they present alongside Dyspepsia?

A
Pernicious Anaemia
Weight loss
Vomiting
Anaemia
Barrett's
Dysphagia 
Family history of upper gi cancer
Peptic Ulcer Disease surgery >20years
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6
Q

Describe Oesophageal carcinomas?

A

More prevelant in males

Can be cured by radiotherapy or surgery

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7
Q

What is a risk factor for oesophageal adenocarcinoma?

A

gastroesophageal reflux

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8
Q

What lifestyle modifications can help oesophageal adenocarcinoma?

A

Stopping Smoking
Loose Weight
Prop up the bed head

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9
Q

What drugs can relieve reflux?

A

antacids

H2 antagonists

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10
Q

Describe H2 antagonists? and name two?

A

Cimetidine

  • Rapid symptom relief
  • Less effective at healing than placebo

Ranitidine

  • Tolerance after 4/52 therapy
  • Poor in preventing relapse and complications
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11
Q

Name three proton pump inhibitors used to treat oesophagitis?

A

Ranitidine
Omeprazole
Lansoprazole - 30mg

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12
Q

What surgery heals oesophagitis?

A

Nissen fundoplication

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13
Q

Describe Barrett’s oesophagus?

A

Intestinal Metaplasia
Irreversible
Increased risk of adenocarcinoma

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14
Q

What is the mangament of dysplasia?

A
Optimise PPI dose
Endoscopic mucosal resection (EMR)
Radiofrequency abalation( HALO)
Argon
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15
Q

What is gastroparesis?

A

Delayed gastric emptying

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16
Q

What are the symptoms of gastroparesis?

A
Feeling of fullness
Nausea
Vomiting
Weight loss
Upper abdominal pain
17
Q

What can cause gastroparesis?

A

Idiopathic
Diabetes mellitus
Cannabis
Medication e.g. opiates, anticholinergics
Systemic diseases e.g. systemic sclerosis

18
Q

What is the management of gastroparesis?

A

Removal of precipitating factors e.g. drugs

Liquid / sloppy diet

Eat little and often

Promotility agents

Gastric pacemaker

19
Q

What are the investigations of gastroparesis?

A

Gastric emptying studies