Gastro-oesophageal Reflux Disease

(GORD)

Abhishek Reekhaye
 Outline
 Presentation
 Examination
 Investigations
 Treatment
 Complications
 GORD
 Dysfunction of lower oesophageal sphincter

 Reflux of gastric contents into stomach

 Presentation
 Heartburn – related to meals and posture
 Retrosternal or epigastric pain
 Acid reflux
 Water brash
 Odynophagia
 Atypical Symptoms
 Chest pain – relieved by antacids

 Respiratory symptoms – chronic cough, SOB

 Associations
 Smoking, alcohol, caffeine
 Obesity
 Big/fatty meals
 Pregnancy
 Hiatus hernia
 Systemic sclerosis
 Drugs
 Examination
 Epigastric tenderness
 Investigations
 FBC
 Upper GI endoscopy if indicated
 Barium swallow – hiatus hernia
 24-hr pH monitoring
Upper GI endoscopy
Barium swallow
 Treatment
 Lifestyle – weight loss, stop smoking, reduce
alcohol

 Medical – simple antacids, PPI

 Surgery – Nissen fundoplication

 Complications
 Oesophagitis, ulcer
 Anaemia
 Benign stricture
 Barrett’s oesophagus
 Oesophageal adenocarcinoma
 Summary
 Retrosternal, burning pain
 Epigastric tenderness
 Endoscopy – oesophagitis
 Full-dose PPI for 1 mth
 H. Pylori not associated with GORD