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Gastro-oesophageal reflux (GORD) - Coggle Diagram
Gastro-oesophageal reflux (GORD)
Definition
The term 'dyspepsia' is used to describe a complex of upper gastrointestinal tract symptoms which are typically present for four or more weeks, including upper abdominal pain or discomfort, heartburn, acid reflux, nausea and/or vomiting.
Gastro-oesophageal reflux disease (GORD) is a common cause of dyspepsia. It is usually a chronic condition where there is reflux of gastric contents (particularly acid, bile, and pepsin) back into the oesophagus, causing predominant symptoms of heartburn and acid regurgitation.
GORD may also be associated with atypical symptoms affecting the oropharynx and/or respiratory tract, such as hoarseness, cough, asthma, and dental erosions.
GORD is thought to be caused by a combination of mechanisms, such as transient relaxation (reduced tone) of the lower oesophageal sphincter, increased intra-gastric pressure (for example straining and coughing), delayed gastric emptying, and impaired oesophageal clearance of acid.
Risk factors
Smocking and alcohol
Trigger foods, such as coffee and chocolate, which may reduce lower oesophageal sphincter (LOS) tone, and fatty foods which delay gastric emptying
Stress and anxiety
Obesity
Complications
Oesophageal ulcers
Oesophageal haemorrhage
Anaemia due to chronic blood loss
Aspiration pneumonia
Barrett's oesophagus
Management
Lose weight
Avoid any trigger foods, such as coffee, chocolate, tomatoes, and fatty or spicy foods
Eat smaller meals and eat their evening meal 3–4 hours before going to bed, if possible.
Stop smoking, if appropriate.
Reduce alcohol consumption to recommended limits, if appropriate.
Review the person's medication, and consider reducing or stopping (if possible and appropriate) any drugs that may cause or exacerbate symptoms, such as: Alpha-blockers, anticholinergics, beta-blockers, calcium0channel blockers, corticosteriods.
Proven GORD
Offer a full-dose proton pump inhibitor (PPI) for 4 weeks, to aid healing: Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole, Esomeprazole
Consider arranging a referral to a gastroenterologist if a person has proven GORD symptoms: That are refractory to treatment, persistent, or unexplained.