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Improving the diagnosis and management of GORD in adults.
Practitioner 2015; 259(1781):27-32, 3P

Abstract

Gastro-oesophageal reflux disease (GORD) is defined as a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many patients with GORD complications such as oesophagitis, and up to a third of patients with Barrett's oesophagus have no reflux or heartburn symptoms. Conversely, patients can be symptomatic even when normal reflux levels are found and there is an absence of mucosal damage. Significant GORD symptoms occur at least once a week in 8.8-26% of Europeans, with equal prevalence of symptoms in men and women. The frequency and severity of symptoms do not accurately predict the degree of oesophageal damage. If patients with GORD also describe symptoms of dyspepsia this should be considered first with H. py/oritesting or direct referral for gastroscopy if the patient is over 55 given the risk of gastric cancer in these patients. Oesophageal disease can account for up to 20% of cases of chronic cough. Symptoms of GORD occur in more than 45% of patients with asthma, and erosive oesophagitis on endoscopy has a 50% higher likelihood of a diagnosis of asthma. GORD is a risk factor for Barrett's oesophagus and oesophageal adenocarcinoma. The risk increases with duration, severity and frequency. Endoscopy should not be routinely offered at initial presentation unless the patient has dysphagia or other symptoms suggestive of upper GI cancer. Smoking cessation and weight loss are beneficial in reducing GORD symptoms. Abdominal obesity causes GORD by elevating intra-abdominal pressure, which promotes reflux and the development of hiatus hernia. GORD symptoms are increased by 70% among daily smokers who have been smoking for more than 20 years.

Authors

No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26529827

Citation

Hopper, Andrew D.. "Improving the Diagnosis and Management of GORD in Adults." The Practitioner, vol. 259, no. 1781, 2015, pp. 27-32, 3.
Hopper AD. Improving the diagnosis and management of GORD in adults. Practitioner. 2015;259(1781):27-32, 3.
Hopper, A. D. (2015). Improving the diagnosis and management of GORD in adults. The Practitioner, 259(1781), pp. 27-32, 3.
Hopper AD. Improving the Diagnosis and Management of GORD in Adults. Practitioner. 2015;259(1781):27-32, 3. PubMed PMID: 26529827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving the diagnosis and management of GORD in adults. A1 - Hopper,Andrew D, PY - 2015/11/5/entrez PY - 2015/11/5/pubmed PY - 2015/12/15/medline SP - 27-32, 3 JF - The Practitioner JO - Practitioner VL - 259 IS - 1781 N2 - Gastro-oesophageal reflux disease (GORD) is defined as a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many patients with GORD complications such as oesophagitis, and up to a third of patients with Barrett's oesophagus have no reflux or heartburn symptoms. Conversely, patients can be symptomatic even when normal reflux levels are found and there is an absence of mucosal damage. Significant GORD symptoms occur at least once a week in 8.8-26% of Europeans, with equal prevalence of symptoms in men and women. The frequency and severity of symptoms do not accurately predict the degree of oesophageal damage. If patients with GORD also describe symptoms of dyspepsia this should be considered first with H. py/oritesting or direct referral for gastroscopy if the patient is over 55 given the risk of gastric cancer in these patients. Oesophageal disease can account for up to 20% of cases of chronic cough. Symptoms of GORD occur in more than 45% of patients with asthma, and erosive oesophagitis on endoscopy has a 50% higher likelihood of a diagnosis of asthma. GORD is a risk factor for Barrett's oesophagus and oesophageal adenocarcinoma. The risk increases with duration, severity and frequency. Endoscopy should not be routinely offered at initial presentation unless the patient has dysphagia or other symptoms suggestive of upper GI cancer. Smoking cessation and weight loss are beneficial in reducing GORD symptoms. Abdominal obesity causes GORD by elevating intra-abdominal pressure, which promotes reflux and the development of hiatus hernia. GORD symptoms are increased by 70% among daily smokers who have been smoking for more than 20 years. SN - 0032-6518 UR - https://www.unboundmedicine.com/medline/citation/26529827/Improving_the_diagnosis_and_management_of_GORD_in_adults_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -