GORD

Question 1

where in the world is it more common?

Answer 1

-western

Question 2

underlying cause of GORD

Answer 2

-reflux of gastric acid, pepsin, bile and duodenal contents back into the oesophagus due to incompetent lower oesophageal sphincter

Question 3

symptoms

Answer 3

• heart burn
• unpleasant taste in mouth
• cough/ hiccups
• hoarse voice
• bad breath
• bloating
• nausea
• weight loss
• chest pain

Question 4

investigations

Answer 4

• endoscopy if >55, symptoms >4 weeks, dysphagia, persistent symptoms despite weight loss
• Ba swallow
• Intraluminal pH monitoring

Question 5

what will be seen on endoscopy if GORD present?

Answer 5

• Barretts oesophagus
• oesophagitis
• peptic stricture

Question 6

complications

Answer 6

• oesophageal carcinoma
• Barretts oesophagus
• oesophagitis
• peptic stricture

Question 7

management

Answer 7

• PPIs
• H2 antagonists
• antacids

Question 8

treatment for GORD

Answer 8

• lose weight, smoking cessation, avoid larger meals at night, avoid alcohol, avoid fatty foods, elevate head of bed
• omezaprole, rabeprazole (PPIs)
• H2RA
• fundoplication

Question 9

mechanism of PPIs

Answer 9

-irreversibly inhibit H+/K+ ATPase pump, leading to reduced HCL secretion

Question 10

what’s a peptic stricture

Answer 10

narrowing of the oesophagus, making it hard to swallow food

Question 11

what is barretts oesophagus

Answer 11

a condition where part of the normal oesophageal squamous epithelium is replaced by metaplastic columnar mucosa to form a segment of ‘columnar lined oesophagus’

Question 12

complications of Barretts oesophagus?

Answer 12

-oesophageal cancer