Gastro Study Resources - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

447

Pages:

2
Author:

Mariam A. A.

Gastro-Oesophageal reflex disease (GERD) Definition Regurgitation of stomach contents into the oesophagus Aetiology • • • • • • Alcohol Tobacco Obesity Pregnancy Hiatus hernia All of these may cause frequent acid reflex thus leading to GERD Pathophysiology Decrease in lower oesophageal sphincter tone or increase in abdominal pressure -> the pressure generated by lower oesophageal sphincter pressure is lower than the intragastric pressure -> backflow of gastric acid or pepsin Signs and Symptoms • • • • • • Dysphagia Regurgitation Odynophagia (painful swallowing) Pressure sensation in the chest Nausea Bloating Diagnosis • • • Endoscopy - Inflammation - Blood - Eroded areas of the mucosa Biopsy - Goblet cell intestinal metaplasia - Lymphatic inflammation - Neutrophilic inflammation - Thinning of squamous epithelium - Elongation of papillae in lamina propria - Dysplasia - Dilation of vascular channels at the tip of the papillae Lab tests - 24hr pH monitoring in lower oesophagus Treatment • • • Medications - PPIs for 8 weeks - H2 receptor antagonist as an alternative - Antiacids for neutralisation Lifestyle - Eating in small portions - Avoid eating 3 hours before sleep or lying down three hours after eating - Avoid foods or meds that trigger the condition or make it worse: ✓ Nicotine ✓ Coffee ✓ Alcohol ✓ CCBs, diazepam etc. Surgery - Antireflexive surgery - Nissen fundoplication - LINX reflux management system

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