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GORD (RISK FACTORS (LOS tone reducing drugs (Smooth muscle relaxants and…

- - - - Epigastric pain: the most common symptom, Duodenal ulcers pain may radiate to back, Bloating, Distention, Gnawing sensation or Heartburn after meals: shortly after meals = Gastric ulcer, 2-3 H afterward = Duodenal ulcer, NVA triad, Chest discomfort, Anaemia symptoms (fatigue, dyspnea), GI Bleeding: Either in stool or vomiting.
    - - Endoscopy demonstrates ulcer
      - Testing for H. pylori infection is often positive, although not diagnostic
  - - - Retrosternal pain: Cramp-like in nature. May be relieved by drinking cold water. Typically affects younger people, Dysphagia, Posturing to aid swallowing, Acid regurgitation, Gradual weight loss
    - - Esophageal manometry and/or esophagram are abnormal and consistent with achalasia.
  - - - Heartburn, Acid regurgitation, Dysphagia & Odynophagia, cough.
    - - Endoscopy may show oesophageal rings, linear furrows, white plaques, exudates and a narrow caliber oesophagus
  - - - Epigastric/ RUQ Pain: Constant pain typically increases in intensity and lasts several hours -Onset after a meal, Nausea, Jaundice: Uncommon.
    - - Ultrasound may show gallstones
  - - - Recurrent for At least 3 months, Epigastric Pain or Discomfort, Belching & Bloating, Satiety, Nausea & vomiting
    - - No definitive differentiating tests., Oesophagitis is absent on endoscopy and PUD excluded
  - - - Epigastric Pain: vague in early-stage disease, Involuntary weight loss, Lymphadenopathy, NVA triad, Progressive dysphagia
    - - Suspected in older adults, Laboratory tests may show anaemia or abnormal LFTs, Tissue biopsies diagnostic
  - - - FHx of CHD, high cholesterol and hypertension, Angina: Chest pain, discomfort, tightness, pressure, -Palpitations, Dyspnoea, Sweating, Nausea or vomiting, Heart attacks (MI) and heart failure
    - - ECG may show ST changes or Q waves, Exercise stress testing may be abnormal
- - - - the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the lower end of the esophagus and stitched in place, reinforcing the closing function of the lower esophageal sphincter. The esophageal hiatus is also narrowed down by sutures to prevent or treat concurrent hiatal hernia, in which the fundus slides up through the enlarged esophageal hiatus of the diaphragm.
  - - - Ranitidine, Famotidine etc
- - - - Coffee
      - Alcohol
      - Chocolate
      - Fatty Foods
        
        Transient LOS stimulated by Fat in the Duodenum
    - - Beta Agonists
      - Anti-cholinergics
      - Nitrates
      - CCBs