GORD Flashcards
(11 cards)
1
Q
If GORD is left untreated, what can it lead to?
A
Oesophagitis Oesophageal stricture Barrett's Oesophagus Ulcers Iron Deficiency
2
Q
What are the causes of GORD?
A
Hiatus hernia Oesophageal dysmobility LOS hypotension Obesity Gastric acid hypersecretion Delayed gastric emptying Smoking Alcohol Pregnancy Drugs (tricyclics, nitrates, anticholinergics) H Pylori
3
Q
What are the symptoms of GORD?
A
Heartburn Burping Acid regurgitation Waterbrash (mouth fills with saliva) Odynophagia (painful swallow)
Noctural asthma
Laryngitis
Sinusitis
Chronic cough
4
Q
What exacerbates/relieves heartburn?
A
Stooping
Lying
Straining
Post-meal
Antacids
5
Q
What causes the odynophagia in GORD?
A
Oesophagitis
Ulcers
6
Q
What are the histological changes in Barrett’s?
A
Squamous epithelium to columnar epithelium
metaplasia-dysplasia-neoplasia
7
Q
What are the differentials of GORD?
A
Oesophagitis due to NSAIDS, herpes, candida Gatric/duodenal ulcer/cancer Cardiac pain Non-ulcer dyspepsia Oesophageal spasm
8
Q
What tests do we do for GORD?
A
Endoscopy if dysphagia of +55 with ALARM
Manometry with 24hr pH
9
Q
What are the ALARM Symptoms?
A
Anaemia Loss of weight Anorexia Recent onset Melaena Swallowing difficulty
10
Q
What lifestyle changes should we recommend?
A
Weight loss Smoking cessation Small regular meals Eat +3hrs before bed Avoid alcohol, caffeine, spicy food, hot drinks, citrus fruits, tomatoes, onions, fizzy drinks, chocolate
11
Q
Which drugs can we give for GORD?
A
Antacids 20mL/8hr
Alginate 10-20mL/8hr PO
PPI e.g lansoprazole 30mg/24hr
H2A - ranitidine 150mg BD
