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Dyspepsia/GORD - Coggle Diagram
Dyspepsia/GORD
Differential diagnosis
Upper gastrointestinal malignancy
Gallbladder or hepatobiliary disease
Pancreatic disease
Cardiac disease
Gastroenteritis
Coeliac
Crohns
IBD
H.pylori
Risk factors
Smoking
Alcohol
Trigger foods (caffeine, chocolate and fatty foods)
Obesity
Medication: Alpha-blockers, anticholinergics, benzodiazepines, beta-blockers, bisphosphonates, calcium-channel blockers, NSAIDS, Nitrates, theophyllines and tricyclic antidepressants.
Pregnancy
Hiatus hernia
Lifestyle
Complications
Oesophageal ulcers
Oesophageal haemorrhage
Anaemia
Oesophageal stricture
Aspiration pneumonia
Barrett's oesophagus
Oral problems such as dental erosions, gingivitis and halitosis
Red flags
Dysphagia
New vomiting persisting for more than 2 weeks
Weight loss
New or worsening upper abdominal pain
Iron deficiency anaemia
Reflux symptoms
Treatment resistant dyspepsia
Management
Lifestyle advice
Raise head of bed when sleeping
Assess stressors and reduce where able
Review all medication including OTC
PPI for 4 weeks then review
If recurring for review and possible endoscopy
Symptoms
Nausea/&vomiting
Abdominal discomfort
Acid reflux
Non-productive cough
Causes
Transient relaxation of the lower oesophageal sphincter
Delayed gastric emptying
Increased intra-gastric pressure (eg coughing or straining)
Impaired oesophageal clearance of acid