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Year Two - Gastroenterology System > Gastro-Oesophageal Reflux Disease (GORD) > Flashcards

Gastro-Oesophageal Reflux Disease (GORD) Flashcards

1
Q

What is gastro-oesophageal reflex disease (GORD)?

A

It is defined as a condition in which gastric acid refluxes from the stomach through the lower oesophageal sphincter and irritates the lining of the oesophagus

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2
Q

Why is the oesophagus more sensitive to gastric acid than the stomach?

A

The oesophagus is lined with squamous epithelium, whereas the stomach is lined with columnar epithelium

Therefore, the stomach is more protected against gastric acid

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3
Q

What are the seven risk factors of GORD?

A

Connective Tissue Disorders

Hiatus Hernia

Obesity

Pregnancy

Smoking

Alcoholism

Caffeine Intake

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4
Q

What are the seven clinical features of GORD?

A

Heartburn

Acid Regurgitation

Dysphagia

Epigastric Pain

Abdominal Distension

Nocturnal Cough

Hoarse Voice

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5
Q

In most cases, how is GORD diagnosed?

A

Clinically

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6
Q

What investigation can be used to investigate GORD? When is it recommended?

A

Endoscopy

It is recommended when individuals present with red flag features, in order to exclude an underlying pathology or the development of complications

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7
Q

What are the six criteria for a two-week wait endoscopy referral?

A

Dysphagia

Old Age > 55 Years Old

Weight Loss

Treatment Resistance

Anaemia

Thrombocythemia

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8
Q

What is the criteria for an urgent endoscopy referral?

A

Gastrointestinal bleeding

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9
Q

In cases where individuals require an upper gastrointestinal endoscopy and take proton pump inhibitors, what advice should be given?

A

They should stop the proton pump inhibitor two weeks before the procedure

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10
Q

What are the five conservative management options of GORD?

A

Smoking Cessation

Alcohol Cessation

Caffeine Reduction

Weight Loss

Nutritional Advice

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11
Q

What are the three pharmacological management options of GORD?

A

Antacid Drugs

Proton Pump Inhibitors (PPIs)

H2 Receptor Antagonist

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12
Q

Name two antacid drugs used to manage GORD

A

Gaviscon

Rennie

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13
Q

When are antacid drugs used to manage GORD?

A

They are over the counter medications that patients can be advised to purchase

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14
Q

What is the mechanism of action of antacids?

A

They work to neutralise stomach acid and inhibit pepsin

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15
Q

How do antacid drugs treat GORD?

A

They can be administered to provide temporary symptomatic relief, however, don’t provide resolution of the underlying oesophageal damage

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16
Q

Name two proton pump inhibitors (PPIs) used to manage GORD

A

Omeprazole

Lansoprazole

17
Q

When are proton pump inhibitors used to manage GORD?

A

They are the first line management option

18
Q

How do proton pump inhibitors (PPIs) manage GORD?

A

They inhibit gastric acid secretion by binding to the hydrogen potassium ATPase pump that resides on the luminal surface of the parietal cell membrane

This provides time for the damaged oesophageal tissue to heal

19
Q

What are three side effects of PPIs?

A

Osteoporosis

Fractures

Hypomagnesaemia

20
Q

When is lansoprazole preferred to omeprazole to manage GORD?

A

When individuals are on clopidogrel

This is due to the fact that omeprazole inhibits CYP2C19 - an enzyme needed to convert clopidogrel into its active metabolite

21
Q

Name a H2 receptor antagonist used to manage GORD

A

Ranitidine

22
Q

When are H2 receptor antagonists used to manage GORD?

A

They are the second line management option

23
Q

How do H2 receptor antagonists treat GORD?

A

They inhibit gastric acid secretion and by binding to histamine type 2 receptors on the basolateral surface of gastric parietal cells

This provides time for the damaged oesophageal tissue to heal

24
Q

What surgery is used to manage GORD?

A

Laparoscopic Fundoplication

25
Q

What is laparoscopic fundoplication?

A

It involves tying the fundus of the stomach around the lower oesophagus to narrow the lower oesophageal sphincter

26
Q

What are the six complications of GORD?

A

Oesophagitis

Oesophageal Ulcers

Oesophageal Stricture

Barrett’s Oesophagus

H.Pylori Infection

Anaemia

Year Two - Gastroenterology System (33 decks)

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