Incompetence of LOS

Symptoms – Heartburn, Epigastric pain and regurgitation worsened when lying.

Gold standard – 24H pH

Complications

Strictures – close to GE juction unlike malignant strictures. Managed with PPI and dilataion.

Barret’s Oesophagus

Metaplastic change to GORD. Intestinal metaplasia is a risk factor for adenoCA.

GORD – – > Barret’s Oesophagus

DDs – Sliding hiatus hernia

Hiatus hernia

Sliding – cardia moves.

Rolling – Greater curvature rolls upto mediastinum.