GORD

Question 1

What 4 failures cause reflux?

Answer 1

1. Lower oesophageal sphincter laxity
2. Faulty intra-abdominal segment valve
3. Faulty pinchcock mechanism
4. Oesophagus not rapidly cleared

Question 2

How common is GORD?

Answer 2

10-20% of Population

Question 3

What age are affected?

Answer 3

60-70 years but can occur at any age

Question 4

Any gender preference?

Answer 4

Males and Females equally

Question 5

What are the main risk factors for GORD? (4)

Answer 5

Alcohol, fatty food, smoking, large meals

Question 6

Other risk factors for GORD (6)

Answer 6

Pregnancy, Obesity, chocolate, coffee, hiatus hernia, drugs (anti-muscarinics, calcium channel blockers, nitrates)

Question 7

Main Symptoms of GORD (4)

Answer 7

Heartburn
Pain aggravated by lying/bending
Regurgitation
Bitter Taste

Question 8

Main Signs of GORD (1)

Answer 8

Epigastric Pain

Question 9

What is the main differential?

Answer 9

Coronary Pain

Question 10

First Line Investigation (2)

Answer 10

Often a clinical diagnosis but can do Endoscopy if Dysphagia or recurrent

Question 11

Other investigation (1)

Answer 11

Intraluminal pH monitoring (excessive reflux <4)

Question 12

First line drug treatment (2)

Answer 12

Antacids e.g Magnesium Trisilicate

Alginates e.g Gaviscon

Question 13

2nd Line Drug Treatment (2)

Answer 13

Proton Pump Inhibitor (Omeprazole, Lansoprazole)

H2 Receptor Antagonist (Ranitidine)

Question 14

Non Medical Treatment (5)

Answer 14

Weight Loss
Sitting Upright
Smoking and Alcohol Cessation
Small, regular meals
Avoid NSAIDs and Bisphosphonates

Question 15

Surgical Treatment

Answer 15

Raises pressure of the oesophageal sphincter-used only in serious cases of GORD

Question 16

Complications

Answer 16

Dysphagia
Peptic Ulcer
Haemoptisis