Gastro-Oesophageal Reflux Disease Flashcards Preview

Year 2 - GI System > Gastro-Oesophageal Reflux Disease > Flashcards

Flashcards in Gastro-Oesophageal Reflux Disease Deck (10):

What is the normal resting pressure of the LOS?

10-15mM above the pressure inside the stomach


What things can happen if the mechanisms that protect the oesophagus from reflux fail?

Transient LOS relaxations
Hiatus hernia
Low oesophageal sphincter pressure
Impaired oesophageal clearance
Increased intra-abdominal pressure
Reduced gastric emptying


What is a hiatus hernia?

Protrusion of part of the stomach through diaphragmatic hiatus into the chest.
- sliding - just the GOJ protrusion
- rolling - entire fundus protrusion


What is Barrett's oesophagus?

When acid reflux from the stomach causes the epithelium in the oesophagus to change from non-keratinised stratifies squamous epithelium into simple columnar


What is the best test used to test for GORD?

Endoscopy- direct visualisation, so you can tell is it's a tumour or acid reflux. Also allows for biopsy at the same time


Name some type of drugs used to treat high acid levels in the stomach.

Antacids - decreases pepsin activity (so pH can increase)
Mucosal agents
H2 receptors antagonists
Prokinetics - increase LOS pressure
PPI inhibitors
Alginates - forms a foamy barrier over the stomach juice


What is the surgical option for treatment of GORD?

Nissan fundoplication
- the fundus of the stomach is wrapped round to LOS, to increase tone
- can't relax, so patients can't vomit, and causes bloating


What are the symptoms of GORD?

Epigastric pain
Non-cardiac chest pain


How can pH monitoring be performed?

A catheter is inserted through the nose and dangles down the oesophagus until 5cm above the LOS
This can detect any acid reflux by measuring the pH at this level


What are the normal mechanisms of controlling acid reflux?

Intrinsic sphincter - thickened layer of circular muscle
Extrinsic sphincter - diaphragm
Angle of His - acute angle created by the cardia at the entrance to the stomach, forming a valve
Secondary peristalsis - clears acid from lower oesophagus