LECTURE: WEEK : 4 OESOPHAGUS AND STOMACH DISORDERS GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD) CLASSIFICATIONS: CAUSES: Reflux of gastric acid (From stomach) is the most common cause of oesophagitis (inflammation of the oesophagus) Clinical condition of GORD/GERD Damage of the mucosal lining (mucosal injury) in the oesophagus as it is not adapted to acidity Most common symptoms Heartburn Difficulty swallowing (dysphagia) Less common symptoms Regurgitation Severe chest pain Oesophagus Diaphragm Stomach RISK FACTORS: Alcohol Tobacco Pregnancy Obesity over the age of 40 Esophagus Stomach LINX derice Magnets move apart Acid rollux and food passes into stomach BARRETT OESOPHAGUS CLASSIFICATIONS: A complication of chronic GORD Intestinal metaplasia within the oesophageal squamous mucosa Increased risk For development of oesophageal adenocarcinoma cancer MultiFactoral Transient lower oesophageal sphincter relaxations The lower oesophageal sphincter (LOS) pressure abnormalities COMPLICATIONS: Oesophageal ulceration Vomiting of blood (hematemesis) Blood in Faeces (melena) Barrett oesophagus Lower oesophageal sphincter (LOS) Reduced oesophageal sphincter tone permitting acid retux 0 MANAGEMENT: Medications Neutralise stomach acid Antacids Reduce stomach acid production H2 blockers Block stomach acid production Proton pump inhibitor's surgery LINK device Acidic conditions From reflux over long periods of time cause regions that shouldn't have columnar cells to now have them A B