GORD Flashcards
Define GORD
Sx or complications caused by gastric reflux into the oesophagus, mouth or even lung–so means reflux with Sx
Aetiology and risk factors of GORD
GORD patients have more frequent episodes of lower oesophageal spinchter relax (normal-but more often)-more common after meals and triggered by fat in duodenum
Sx can be caused by damage of the epithelium(oesophagus), vagal stimulation (coughing/ashtma), lung aspiration
Risk factors-not that connected-modest correlation at best FHx of GORD Older age Hiatus hernia Obesity NSAID, smoke, alcohol, stress, diet
Epidiemology of GORD
Very common 10-30% of people in developed countries
Lower in Asia
association with most things are modest at best
Signs and Sx of GORD
Most common-
Heartburn-burn in chest after meal (worse when lying)
Acid reflux (bitter taste in mouth)
Dysphagia (not progressive) Asthma Bloating Lump in throat Halitosis
mainly-> exclude everythin else that can cause the thing (Dysphagia-cancer) etc
Investigations of GORD
PPI trial therapy-should provide Sx improvement (does not prove its GORD tho-ulcers and others also react)
OGD-if Sx are caused by cancer, presence of barrels oesophagus
Barium swallow-other causes of dysphagia
Management of GORD
Mild, typical and most common-
antacid, H2 inhibitor, PPI
and mostly lifestyle-stop smoking, eat better (less coffee/spicy), less alcohol, lose weight
and monitor if last for over 5 years, or old, or with anaemia-OGD
PPI should be continued if barrets oesophagus, Sx without PPI
surgery is a possibility
Complications of GORD
Barrets oesgophagus-> oesophageal adenocarcinoma
oesophageal ulcer/perfortation/heammorhage
Oesophageal stricture-as repair, collagen deposition-usually issue with solids
Prognosis of GORD
Good-most people don’t have Sx after PPI
they do replapse without PPI but need to weight risk of PPI vs risk of GORD
on a 7 year follow up, risk of adenocarcnima is about 0.1%
