GI: Common gastric disease Flashcards Preview

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Flashcards in GI: Common gastric disease Deck (16)
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1
Q

What is dyspepsia and how common is it?

A

Dyspepsia is upper GI symptoms (stomach pain in epigastric region) lasting 3+ months
Up to 40% of adults suffer with dyspepsia

2
Q

What is GORD? How does it present?

A

Gastic oesophageal reflux disease

Symptoms include heartburn, cough, sore throat, dysphagia

3
Q

What are the causes of GORD?

A

Obesity - higher intra abdo pressure
Hiatus hernia - upper part of stomach herniates into thorax via lower oesophageal sphincter
Delayed gastric emptying (eg diabetes) raises the intra gastric pressure
Problems with the lower oesophageal sphincter

4
Q

What is a complication of GORD?

A

Can cause Barretts oesophagus which is a metaplastic change from squamous to columnar epithelium which increases the risk of developing adenocarcinoma by 30-40x

5
Q

How is GORD treated?

A

Lifestyle modifications: quit smoking, lose weight, eat smaller more frequent meals, cut down alcohol
Pharmacological: OTC antacids, H2 antagonists, PPIs
Surgery: (rare) wrap fundus around lower oesophagus to support the sphincter

6
Q

What are the causes of acute gastritis?

A

Heavy use of NSAIDs (inhibit prostaglandins), heavy alcohol, chemotherapy, bile reflux through pyloric sphincter

7
Q

What are the symptoms of acute gastritis?

A

Asymptomatic, or pain nausea vomiting and occasionally bleeding which can be fatal

8
Q

What are the causes of chronic gastritis?

A

Most common cause is helicobacter pylori infection
Can be autoimmune - antibodies against parietal cells (can also lead to pernicious anaemia because parietal cells secrete intrinsic factor needed for absorption of vit B12)

9
Q

What are the symptoms of chronic gastritis?

A

H Pylori infection - asymptomatic or pain vomiting nasea, or may develop symptoms from complications eg peptic ulcers, adenocarcinoma
Autoimmune causes - symptoms of anaemia, anorexia,

10
Q

What is peptic ulcer disease?

A

Ulceration through the gastric mucosa - must extend through muscularis mucosa.
Most common in first part of duodenum and lesser curve of the stomach

11
Q

What causes peptic ulcer disease?

A

Mucosal injury from stomach acid, h pylori or NSAIDs

12
Q

What are the symptoms of peptic ulcer disease?

A

Epigastric pain - burning, follows meals, worse at night with duodenal ulcers
Serious symptoms - bleeding, early satiety, weight loss

13
Q

How is H pylori treated?

A

Triple therapy - PPI + clarithromycin + amoxicillin

14
Q

What is Zollinger-Ellison syndrome?

A

A non beta islet cell gastrin secreting tumour of the pancreas
Causes proliferation of parietal cells so lots of acid produced leading to severe ulceration of stomach and small bowel

15
Q

How common is stomach cancer?

What are the risk factors?

A

Very common - 3rd most common cancer in the world

Risk factors - male, h pylori, diet, smoking

16
Q

What are the symptoms of stomach cancer?

A

Usually presents late - large before onset of symptoms

Dysphagia, loss of appetitie, malaena (dark sticky poo), weight loss, nausea vom, virchows nodes

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