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Flashcards in Oesophagus Deck (64)
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1

What is GORD

Gastro-oesophageal reflux disorder

2

When does a patient with GORD typically have worsening symtpoms

After meals

3

What prevents reflux in health

Lower oesophageal sphincter pressure
Angle of Hiss: oblique angle between cardia and oesophagus - anatomical barrier
Oesophageal clearance: any material that gets back into the oesophagus will be rapidly cleared by peristaltic contractions

4

What is a hiatus hernia

herniation of the stomach in to the thorax

5

Are all hiatus hernias symptomatic

No

6

What are the 2 forms of hiatus hernia

Sliding and rolling

7

What is the most common form of hiatus hernia

Sliding

8

How does a hiatus hernia cause reflux

Reducing the LOS pressure
Increasing the TLSORs
Straightening out the angle of Hiss

9

What is a gastric volvulus

When the stomach twitsts on itself causing severe pain and dysphagia

10

Define gastroparesis

Any condition that delays gastric emptying

11

What can increase the gastric volume

Pregnancy, binge drinking, poorly controlled diabetes

12

What can cause an increase n the intra-abdominal pressure

Pregnancy
Obesity
Chronic cough

13

What increases the gastric acid production in the stomach

Smoking
eating fat and calorie rich foods
binge drinking
regular use of NSAIDs

14

What are some of the clinical features of GORD

Heartburn
Fluid/ Food regurgitaiton
Waterbrash
Nocturnal cough
Chest pain
Dysphagia or odynophagia

15

What is the first line investigation

Endoscopy

16

What is helpful if surgery is being considered

24 h pH measurement

17

What is helpful if surgery is being considered

24 h pH measurement

18

What is oesophagitis

Endoscopic change ranging from minor erythmea to frank ulceration and stricturing

19

What does an oesophageal stricture result in

Narrowing of the distal oeosphagus following repeated peptic ulceration and scarring

20

How does an oesophageal stricture present

Dysphagia

21

What is the treatment for an oesophageal stricture

Endoscopic dilatation and long term PPIs

22

What is Barrett's oesophagus

A metaplasia of distal oesophageal mucosa from squamous to columnar epithelium caused by an adaptive response to chronic acid exposure

23

Barrett's oeosphagus is usually symptomatic. True or False.

False. It is usually asymptomatic

24

What are 4 risk factors for Barrett's oesophagus developing into carcinoma

White males
OVer 50 year olds
Obese
Smokers

25

How is a diagnosis of Barrett's oesophagus made

BAsed on mucosal appearances and histology

26

What are the treatment options for Barrett's oeosphagus

Endoscopic ablation through photodynamic therapy - has lots of side effects

27

What might be considered when high-grade dysplasia is observed

Oesophagectomy

28

What are the 2 main forms of conservative management for GORD

Lifestyle modification - weight loss, smoking cessation, elevation of bed head, avoiding fatty meals before bed
Antacids - provide symptoms relief

29

What are the 2 main medical ways of managing GORD

H2 receptor antagonists- need to be taken less frequently than anatacids but are just as effective
PPI - achieve symptom relief - they also heal oesophagitic mucosa

30

Who is laparoscopic or open fundoplication suitable for

Patients with large hiatus hernias