Oesophagopharyngeal Risk Factors And Complications

Question 1

What are the risk factors for Barrett’s oesophagus?

Answer 1

Chronic GORD

Hiatus hernia

Smoking

Central obesity (also cancer development risk)

Male sex (7 times more likely - also cancer development risk)

50+

Question 2

What are the risk factors for oesophageal cancer?

Answer 2

Most important: Smoking and Alcohol

• synergistic effect
• dose effect

GORD - higher risk if nocturnal or for >20 years (10% get Barrett’s oesophagus)

Diet lacking:

• Vegetables
• Fruit
• Dairy products
• Folate
• Vitamin A
• Riboflavin

Diet with too much pickles

Iron deficient anemia due to Peterson brown Kelly syndrome

Question 3

Where do oesophageal cancers metastasise to?

Answer 3

Local nodes: paraoesophageal, anterior jugular chain

Supraclavicular nodes

Thoracic nodes: Mediastinal, paracardial

Gastric: Coeliac nodes

Subdiaphragmatic nodes

Lung

Liver

Adrenal glands