Internet-based resources on GORD

Dr Keith Barnard recommends websites relating to this week's Clinical Review.

FUNDOPLICATION

This relatively new laparoscopic procedure appears to offer hope for those with intractable symptoms from GORD - especially those who have a hiatus hernia - and is more effective than previous open procedures.

This material is from a book, and it is only the first eight pages of this 20-page PDF that need concern you.

There is a discussion about indications for the procedure, some simple diagrams, and endoscopic images explaining what goes on.

If the English is less than perfect, the content and presentation are first class.

Why go there: a clear explanation.
Downside: none.
Information from: Laparoscopy Hospital.com
Address: www.laparoscopyhospital.com/Book11.pdf

PATIENT INFORMATION

If you recommend these pages to your patients, you might have to explain that GERD and GORD are the same - because Americans forget about the 'o' in oesophagus - but apart from that, this is a clean-looking and comprehensive site.

There are some good, coloured drawings that help explain the mechanics of GORD and all that patients need to know about symptoms and diagnosis.

The management advice is surprisingly non-technical for the US, with useful illustrations on blocking up one end of the bed.

Fundoplication also receives a brief mention.

Why go there: easy to understand.
Downside: US spelling.
Information from: West Shore Endoscopy Centre.
Address: www.endowsec.com/pated/ecdgs39.htm

DON'T GO HERE

This makes a change from the herbal remedy bashing that I occasionally engage in - with some justification according to the latest research.

This website tries to make you buy a report at a cost of about £20. This report contains advice that will cure (yes, cure) oesophageal reflux and hiatus hernia within two hours, as long as you live within 50 miles of a grocery store, because that is where the secret lies.

Apples are involved.

Before you buy, you have to agree with the proprietor, Bob, that his report might make you angry with your doctor for not telling you about these natural remedies while you suffered for all these years, but agree not to harm him or her in any way.

You just couldn't make this up if you tried.

Why go there: to convince yourself it's real.
Downside: some people will part with money.
Information from: Barton Publishing Inc.
Address: www.refluxremedy.com/order.htm

- Dr Barnard is a former GP in Fareham, Hampshire

- Clinical review, page 39

WEBSITE OF THE WEEK

I've raved about this Finnish site before when the subject of discussion was the lower GI tract, but it is just as good at the top end.

Here are hundreds of high-resolution images, such as the hiatus hernia shown in the picture, but better still are the video clips of endoscopic procedures that show all grades of reflux oesophagitis, hiatus hernia and Barrett's oesophagus. The address given here takes you straight to a video of reflux oesophagitis, and an on-screen menu leads you to all the other goodies.

I suppose if you are a GPSI who wields an endoscope you might find all this rather passe, but I believe most of us will find these excursions into the world beyond the wisdom teeth quite fascinating.

You need RealPlayer and broadband to use this properly, but I can't believe there are many GPs out there who are still on dial-up.

Why go there: superb images.
Downside: quirky music while you watch.
Information from: Gastrolab.
Address: www.gastrolab.info/tv117.htm

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