Brief Summary Of Gastro-esophageal Reflux

Brief Summary Of Gastro-esophageal RefluxGastro esophageal reflux is caused by retrograde flow of gastric contents through an incompetent gastro-esophageal junction. It is a common condition among the general adult population.

Risk factors

  • Smoking
  • Alcohol
  • Coffee
  • Fatty food
  • Big meals
  • Obesity
  • Hiatus hernia
  • Tight clothes
  • Pregnancy
  • Drugs e.g TCA’s anticholinergics, nitrates, alendronate
  • Systemic sclerosis
  • Surgery for achlasia

Conditions Caused by GERD

Long standing GERD leads to different complications that includes:

  • Oesophagitis defined by mucosal breaks with or without esophageal ulcers
  • Benign esophageal stricture
  • Intestinal metaplasia leading to Barrett’s esophagus.
  • Esophageal haemorrhage
  • Anemia

Clinical Presentation

Patients present with different clinical symptoms that suggest GERD to be the underlying cause

1. Heart burn: It is the most common symptom. There is burning retrosternal or epigastric pain which worsens on bending, stooping or lying and with hot drinks. It is mostly relieved by taking antacids.  Continue reading “Brief Summary Of Gastro-esophageal Reflux”

Approach To A Patient Presenting With Hoarseness

Approach To A Patient Presenting With HoarsenessDefinition Of Hoarseness
Hoarseness is a change in the pitch or quality of the voice caused by abnormalities of vocal cords.
Etiology
Local Causes:
  • URTI ( most common cause )
  • Laryngitis
  • Trauma to the vocal cords: shouting, coughing, vomiting, instrumentation.
  • Hypothyroidism
  • Acromegaly
  • Chronic acid reflux
  • Allergies
  • Heavy smoking or drinking or both
  • Carcinoma
Neurological Causes:
  • Laryngeal nerve palsy
  • Motor neuron disease
  • Myasthenia gravis
  • Multiple sclerosis
Muscular Causes:
  • Muscular dystrophy
Functional Cause.
  • Sometimes no definitive organic cause can be identified and it might be due to psychological causes.
Investigations: