Flashcards in Gastro-oesophageal pathology Deck (22):
What is the aetiology of hiatus hernia?
- Increased intra-abdominal pressure (e.g. obesity, pregnancy, trauma, low residue diet).
- Diaphragmatic laxity (e.g. previous surgery, connective tissue disorders)
What is Barrett's oesophagus?
Metaplasia of the epithelial cells of the lower part of the oesophagus. (columnar- lined oesophagus).
What are the symptoms of acute gastritis?
Dyspepsia, heartburn, nausea, vomiting, epigastric pain
What is the aetiology of gastritis?
Alcohol, smoking, aspirin, NSAIDs, chemotherapy, H. Pylori, HSV, CMV, stress, trauma, burns.
What are the symptoms of chronic gastritis?
Usually symptoms are absent or mild (without complications)- episodic pain, nausea +/- vomiting
What percentage of peptic ulcers are duodenal?
What percentage of peptic ulcers are gastric?
What is peptic ulcer disease?
Ulceration of the GI mucosa caused by exposure to the action of gastric acid and pepsin.
Complications of peptic ulcers?
Bleeding, perforation, fibrosis, stricture, obstruction, anaemia, pain, increased risk of malignancy.
Stomach cancer is particularly common in which country?
Japan (due to diet)
Where do GI cancers classically metastasise to?
Liver and lungs
What is achalasia?
Loss of nitrergic 'relaxing' neurons, causing an aperistaltic oesophagus.
Achalasia is primarily a disorder of motility of the lower oesophageal or cardiac sphincter - food often gets stuck and is brought back up.
How do we treat achalasia?
Treatment is aimed at disrupting the lower oesophageal sphincter:
- Botulinum toxin
What is functional dyspepsia?
Pain or discomfort in the upper abdomen with no definite structural or biochemical explanation.
Treated with CBT, tricyclics.
Where are the 3 narrow points of the oesophagus?
1) Cricopharyngeal sphincter
2) Where it is crossed by the arch of the aorta and the Left main bronchus.
3) Where it passes through the diaphragm
How is dysphagia in cancer different from other causes of dysphagia?
Progression from dysphagia of solids to dysphagia of liquids (over time).
What is a Mallory Weiss tear? What are the causes?
A tear in the mucosa at the junction between the oesophagus and the stomach.
Caused by severe alcoholism, retching, coughing or vomiting.
What are the two complications of GORD?
Oseophageal stricture formation
What causes odynophagia?
Oesophagitis (due to GORD)
Infections of oesophagus (HSV, candida)
Drugs, such as slow release potassium and bisphosphonates
How can we treat Barrett's oesophagus?
1) oesophagectomy (young fit patients)
2) endoscopic mucosal resection (localised areas)
3) endoscopic ablative therapies (e.g. photodynamic therapy, radiofrequency ablation)
How do we treat achalasia?
Endoscopic balloon dilatation OR Heller's cardiomyotomy: surgical division of the LOS.
Medical (in e.g. elderly and frail who cannot undergo surgery): oral nitrates, nifedipine, endoscopic botulinum toxin injection into the LOS.