Gastro-oesophageal reflux disease (GORD) Flashcards
(30 cards)
What is dyspepsia?
A collection of upper GI symptoms (e.g. upper abdominal pain, bloating, nausea, heartburn) lasting ≥4 weeks.
What are some causes of dyspepsia?
GORD, peptic ulcers, malignancy, drug side effects, or functional dyspepsia (no clear cause).
What drugs commonly worsen dyspepsia?
NSAIDs, aspirin, corticosteroids, bisphosphonates, calcium-channel blockers.
When should urgent endoscopy be done in dyspepsia?
If dysphagia, GI bleeding, or age ≥55 with weight loss and dyspepsia.
First-line treatment for uninvestigated dyspepsia?
4-week PPI and test for H. pylori.
Management of functional dyspepsia if H. pylori negative?
Trial of PPI or H2-receptor antagonist.
What is a peptic ulcer?
A break in the gastric or duodenal mucosa. Main cause: H. pylori infection and NSAID use.
Key complications of PUD?
GI bleeding, perforation, gastric outlet obstruction.
High-risk factors for NSAID-induced ulcers?
Age >65, high-dose/long-term NSAIDs, concurrent anticoagulants/SSRIs/steroids, comorbidities, smoking, alcohol.
Treatment of NSAID-induced ulcer?
PPI or H2RA for 8 weeks; eradicate H. pylori if positive.
What is GORD?
Chronic reflux of stomach contents (acid, bile, pepsin) into the oesophagus.
What are complications of GORD?
Oesophagitis, strictures, ulceration, anaemia, aspiration pneumonia, Barrett’s oesophagus.
How is GORD classified?
Non-erosive (normal endoscopy) vs erosive (oesophagitis visible on endoscopy).
First-line drug treatment for confirmed GORD?
PPI for 4–8 weeks.
What if GORD symptoms persist despite PPI?
Try H2RA or double PPI dose; consider adding H2RA at night.
Who needs long-term PPI therapy?
Patients with severe oesophagitis or oesophageal stricture.
What is Barrett’s oesophagus?
A pre-malignant condition where oesophageal squamous epithelium is replaced by columnar epithelium due to chronic GORD. It increases the risk of oesophageal adenocarcinoma.
What are antacids used for?
Short-term relief of dyspepsia, heartburn, and indigestion by neutralising stomach acid.
Give examples of commonly used antacids.
Magnesium hydroxide, aluminium hydroxide, calcium carbonate.
What is an alginate and how does it work?
E.g. Gaviscon – forms a raft that floats on gastric contents to prevent reflux.
When should antacids be taken in relation to meals?
Typically after meals and at bedtime for longer-lasting relief.
What are key interactions with antacids?
They reduce the absorption of drugs such as:
Tetracyclines
Quinolones (e.g. ciprofloxacin)
Bisphosphonates
Levothyroxine
Iron
🟠 Spacing doses by at least 2 hours is advised.
What is the mechanism of action of PPIs?
They irreversibly inhibit the H⁺/K⁺ ATPase enzyme (proton pump) in gastric parietal cells to suppress acid secretion.
What is the typical duration of a PPI course for dyspepsia or GORD?
4–8 weeks.
