GORD

Question 1

if reflux is prolonged - what can it lead to ?

Answer 1

Oesophagitis
Stricture
Barrett’s oesophagus

Question 2

what is barrett’s oesophagus?

barrett’s oesophagus increases risk of?

Answer 2

Squamous epithelium replaced by columnar epithelium

oesophageal adenocarcinoma

Question 3

Ix?

Answer 3

Upper GI endoscopy

Question 4

if endoscopy is normal - what other tests could you do?

Answer 4

24h oesophageal pH monitoring

Question 5

Tx of GORD

lifestyle changes ?

Answer 5

weight loss
smoking stop 
small, regular meals 
reduce hot drinks 
avoid fizzy, citrus drinks and spicy foods

Question 6

Tx of GORD

what drugs should patient avoid?

Answer 6

• anticholinergics, NSAIDs, calcium channel blockers

Question 7

Tx of GORD (endoscopically proven GORD/oesophagitis)

• for how long do you give full dose PPI?
• if response?
• if no response?

Answer 7

• 1-2 months
• change to low dose Tx
• double dose for one month

Question 8

Tx of GORD (endoscopically -ve GORD)

• for how long do you give full dose PPI?
• if responded?
• if no response?

Answer 8

• 1 month
• lower dose
• add H2 blocker (ranitidine) or prokinetic for 1 month