Gastroesophageal Acid Reflux

Posted in Gastroesophageal Reflux, Gastrointestinal by Dr Ryan

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Gastro-esophageal reflux disease (GERD) is seen in healthy people. GERD is thought to have a multifactorial etiology rather than a single cause. Contributing factors include the caustic materials that are refluxed, a breakdown in the defense mechanisms of the esophagus and a functional abnormality that results in reflux.

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Definition

Gastroesophageal reflux disease may be defined as symptoms or tissue damage caused by reflux of gastric contents with or without esophageal inflammation. However, this definition can blur the distinction between healthy people and those with GERD because a mild degree of esophageal reflux is considered physiologic. Other accepted definitions of GERD include reflux esophagitis identified by endoscopic examination and histologic esophagitis identified by examination of tissue samples.

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Peptic Ulcer Disease Symptom

Posted in Upper GI Disorders, Gastrointestinal by Dr Ryan

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Common Peptic Ulcer Disease Symptoms

Pain

Epigastric pain (dyspepsia), is present in 80-90% of patients. However, this complaint is not sensitive nor specific enough to serve as a reliable diagnostic criterion for peptic ulcer disease. The clinical history cannot distinguish duodenal from gastric ulcers accurately. Less than 1/4 of patients with dyspepsia have ulcer disease at endoscopy. In patients with NSAID-induced ulcers, up to half are asymptomatic.

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Hyoscine Vs Metoclopramide

Posted in Medications, Gastrointestinal by Dr Ryan

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Interesting thing that I realised during my course (Graduate Diploma for Family Physician) is that we should not prescribe hyoscine (commonly known as buscopan) together with metoclopramide (maxalon). The reason is because hyoscine is an anti-spasmodic medication which stops abdominal cramps, and metoclopramide has prokinetic properties which helps with gastric emptying (therefore, prevents vomitting).

When you take both of them together, their properties are negated and none of them works! Or they might not work as well as if you take either one on its own!