GORD Flashcards
1
Q
A
2
Q
define GORD
A
Gastro- oesophageal reflux disease, prolonged or recurrent reflux of the gastric contents into the oesophagus
3
Q
describe the pathophysiology behind GORD
A
- Reduced tone of LOS- Lower oesophageal sphincter- decreases pressure
- increase in transient LOS relaxation
- increased mucosal sensitivity to gastric acid
- more potential for free up passage of acid
- reflux of gastric acid, pepsin, bile and duodenal contents back into oesophagus
4
Q
epidemiology in GORD
A
more common in men
5
Q
what are the symptoms of GORD?
A
- heartburn
- retrosternal burning chest pain
- worse when lying down - odynophagia
- pain when swallowing - chronic cough + nocturnal asthma
- regurgitation
6
Q
what are complcations of GORD?
A
- Barretts oesophagus
- oesophageal cancer
7
Q
what are the causes of GORD?
A
- increased intraabdo pressure- obesity, pregnant
- hiatal hernia- mostly with sliding, LOS sphincter can’t close propperly
- drugs- antimuscarinics
- scleroderma- scarred LOS
8
Q
how is GORD diagnosed?
A
- If no red flags
- go straight to treatment
- if red flags
- endoscopy- oesophagus or barretts oesophagus
- oesophageal manometry- measure LOS pressure + monitor gastric acid pH
9
Q
what are the red flags for GORD?
A
dysphagia
haematomesis
weight loss
10
Q
what is the treatment for GORD?
A
- Lifestyle changes ( conservative)
- antacids
- protein pump inhibitors
- H2 receptor antagonist
- last resort: surgical tightening of LOS
11
Q
what is the pathophysiology of Barents oesophagus?
A
- complication of GORD
- oesophagus epithelium undergoes metaplasia squamous —> collumnar epithelium with goblet cells
- always involve hiatal hernia
12
Q
what is the percentage of GORD patients develop Barrett’s oesophagus?
A
10%
13
Q
what does barretts oesophagus increase the risk of?
A
adenocarcinomas
14
Q
what is the epidemiology for barretts oesophagus?
A
- middle aged Caucasian male with a history of GORD + progressively worsening dysphagia
15
Q
how do you diagnose barretts oesophagus?
A
biopsy
