GI transport + GI Problems and Pharmacological solutions - GORD

Question 1

What is Gastro-Oesophageal Reflux Disease (GORD)

Answer 1

GORD is the regurgitation of acidic contents, through
LOS and into the lower oesophagus. The acid injures
the oesophagus and thus causes it to become inflamed.

Question 2

When does GORD occur?

Answer 2

It can occur when there’s a defect in the anti-reflux
barrier i.e.

1. Lower oesophageal sphincter (closes after bolus passes)
2. Abdo pressure acting on intra-abdo parts of oesophagus
3. Pinchcock effect of the diaphragm on oesophagus
4. Oblique angle between oesophagus and stomach
5. Plug-like action of the mucosal folds (occludes lumen of gastro-oesophageal junction)

Question 3

What are the risk factors of GORD?

Answer 3

Obesity

Peptic ulcers

Hiatal hernia

Pregnancy

Diabetes

Asthma

Connective tissue
disorders

Zollinger-Ellison
syndrome

Smoking, alcohol and
coffee

Question 4

What are the complications of GORD?

Answer 4

Acid regurgitation- water brash

Oesophagitis

Barrett’s Oesophagus

Adenocarcinoma

Stricture (fibrosis)

Bleeding (peptic ulcer may bleed)

Question 5

How can we manage GORD?

Answer 5

Lifestyle-
reduce risk factors
Modulate exacerbation

Pharmacological
Antacids e.g. CaCO3 (Pepto Bismol) Mg(OH)2
h2 receptor antagonists (Ranitidine [Zantac] and
Famotidine [Pepcid]0
PPI (Omeprazole [Prilosec])
Metoclopramide (anti-emetic)

Surgical
fundoplication