Disorders of the Oesophagus

Question 1

What is Barrett’s oesophagus?

Answer 1

the metaplasia of lower oesophageal squamous epithelium to gastric columnar epithelium

Question 2

what is metaplasia?

Answer 2

reversible change from one differentiated cell type to another

Question 3

what is Barrett’s oesophagus usually caused by?

Answer 3

chronic acid exposure as a result of malfunctioning lower oesophageal sphincter

Question 4

what does the acid in Barrett’s oesophagus do?

Answer 4

the acid irritates the oesophageal epithelium, leading to a metaplastic change

Question 5

what is the most common symptom of Barrett’s oesophagus?

Answer 5

long-term burning sensation of indigestion

Question 6

how can Barrett’s oesophagus be detected?

Answer 6

via endoscopy of the oesophagus

Question 7

what are patients found with Barrett’s oesophagus monitored for?

Answer 7

any cancerous changes

Question 8

what are the clinical features of Oesophageal carcinoma?

Answer 8

1. dysphagia

2. weight loss

Question 9

what is dysphagia?

Answer 9

difficulty swallowing

Question 10

when and how does dysphagia become worse?

Answer 10

dysphagia becomes progressively worse over time as the tumour increases in size, restricting the passage of food

Question 11

what are the 2 major types of oesophageal carcinomas?

Answer 11

squamous cell carcinoma and adenocarcinoma

Question 12

what is squamous cell carcinoma?

Answer 12

the most common subtype of oesophagus cancer

Question 13

where can squamous cell carcinoma occur in the oesophagus?

Answer 13

at any level of the oesophagus

Question 14

what does adenocarcinoma occur?

Answer 14

in the inferior 1/3 of the oesophagus

Question 15

what is adenocarcinoma associated with?

Answer 15

Barrett’s oesophagus

Question 16

where does adenocarcinoma normally originate?

Answer 16

in the metaplastic epithelium of Barretts’ oesophagus

Question 17

What are oesophageal varices?

Answer 17

abnormally dilated sub-mucosal veins (in the wall of the oesophagus) that lie within this anastomosis

Question 18

when are oesophageal varices usually produced?

Answer 18

when the pressure in the portal system increases beyond normal

Question 19

what is portal hypertension?

Answer 19

when the pressure in the portal system increases beyond normal

Question 20

when does portal hypertension most commonly occur?

Answer 20

secondary to chronic liver disease e.g. cirrhosis or an obstruction in the portal vein

Question 21

what are varices predisposed to?

Answer 21

bleeding, with most patients presenting with haematemesis

Question 22

what is haematemesis?

Answer 22

vomiting of blood

Question 23

which group of people are at a high risk of developing oesophageal varices?

Answer 23

alcoholics