Upper GI

Question 1

What is Gastro-oesophageal reflux disease (GORD)?

Answer 1

A common condition where stomach acid leaks out of the stomach and into the oesophagus (gullet).

Question 2

What are the complications of GORD?

Answer 2

1.STRICTURE 2.BARRETT’S 3.CANCER

Question 3

What’s the treatment of GORD?

Answer 3

Elevate head of bed 
No smoking 
No alcohol 
Reduce fat in diet 
Reduce size of meals 
Lose weight
Avoid certain foods eg chocolate, coffee 
Avoid certain drugs eg anticholinergic, theophylline

Question 4

What is oesophagitis?

Answer 4

Inflammation of the esophagus. It may be acute or chronic.
Symptoms:
Heartburn (pain in chest/abdomen and may radiate to neck/jaw)
Nausea
Postprandial worsening of symptoms
Symptoms may be relieved by antacids.

Question 5

What are the causes of oesophagitis?

Answer 5

Infectious:
Forms of infectious esophagitis are typically seen in IMMUNOCOMPROMISED people. Types include:
1. Fungal:
Candida (Esophageal candidiasis)
2. Viral
Herpes simplex (Herpes esophagitis)
3. Cytomegalovirus
Endoscopy can be used to distinguish among these conditions.

Other causes:
The most common cause is gastroesophageal reflux disease (GERD, or GORD in British English). If caused by GERD, the disease is also called reflux esophagitis.
Chemical injury by alkaline or acid solutions may also cause esophagitis, and is usually seen in children, as well as in adults who attempt suicide by ingestion of caustic substances.
Physical injury resulting from radiation therapy or by nasogastric tubes may also be responsible.
Pill esophagitis
Hyperacidity
Alcohol abuse
Eosinophilic esophagitis is a poorly understood form of esophagitis, which is thought to be related to food allergies.

Question 6

What are Gastrointestinal stromal tumors (GISTs)?

Answer 6

The most common mesenchymal tumors of the gastrointestinal tract.

Question 7

What is gastritis?

Answer 7

Inflammation of the lining of the stomach and has many possible causes. Common causes of gastritis are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Gastritis may also develop after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting and pernicious anemia. Some may have a feeling of fullness or burning in the upper abdomen.

Question 8

How can gastritis be diagnosed and how is it treated?

Answer 8

An esophagogastroduodenoscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis.
Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given, but more often oral B12 supplements are recommended.

Question 9

What disease can helicobacter pylori bacteria cause?

Answer 9

• Gastritis
• Ulcer
• Gastric Lymphoma
• Cancer

Question 10

What types of gastric tumour are there?

Answer 10

1. Adenocarcinoma
2. Lymphoma
3. GIST
4. Inflmmatory fibroid polyp

Question 11

What’s the staging of gastric adenocarcinoma?

Answer 11

T1 : MUCOSA SUBMUCOSA
T2: MAIN MUSCULAR WALL
T2: SUBSEROSAL FAT
T3: INVOLVEMENT OF PERITONEAL SURFACE
T4: ADJACENT ORGAN
N0 
N1
M0 
M1