Pathology of GI Tract: GERD, Peptic Ulcers, Crohn's and Ulcerative Colitis Flashcards
(22 cards)
What is a Hiatal Hernia and what are the two types?
when the upper part of the stomach protrudes through
the diaphragm into the chest
- Sliding hiatal hernia: stomach slides up and down through the diaphragm opening
- Paraesophageal hiatal hernia: stomach bulges alongside the esophagus (more serious)
What is Esophagitis and what are causes?
inflammation of the esophageal mucosa
- irritants
- infections
- allergies
- uremia
- anti-cancer therapy
What is Reflex Esophagitis (GERD)?
chronic condition where stomach acid frequently flows back (refluxes) into the esophagus
What are common causes of GERD (reflux esophagitis)?
- CNS depressants
- Hypothyroidism
- Pregnancy
- Alcohol, tobacco
- Nasogastric (NG) intubation
What is a major complication of GERD?
↑ risk of Barrett’s esophagus & adenocarcinoma
How does GERD affect the oral cavity?
- enamel erosion, dry mouth, and burning sensations due to acid exposure
- acid irritates oral mucosa, leading to ulcers and erosion
What is Barrett’s esophagus?
normal esophageal squamous epithelium is replaced by metaplastic columnar epithelium due to chronic reflux → salmon-colored mucosa on endoscopy
What is a major complication of Barrett’s esophagus?
Significantly ↑ risk (10–55x) of esophageal adenocarcinoma
What are Esophageal Papillomas?
benign papillary proliferations of squamous epithelium with fibrovascular cores
What are Oral Cavity Papillomas?
benign intraoral squamous proliferation associated with low risk HPV 6 and 11
What are risk factors for esophageal squamous cell carcinoma (SCC)?
- diet
- lifestyle
- esophageal disease
- genetics
What are the growth patterns of esophageal tumors?
- Type A: Exophytic (protruding)
- Type B: Infiltrative (spreads within wall)
- Type C: Excavated (ulcerated center)
How does squamous cell carcinoma of the esophagus spread?
local and lymphatic spread (depending on the site of the tumor)
What is oral squamous cell carcinoma?
cancer that affects the lining of the mouth, often appearing as ulcerated or exophytic growths
What is chronic gastritis and what causes it?
long-term inflammation of the stomach lining mainly due to H. pylori infection, leading eventually to mucosal atrophy and/or epithelial metaplasia
How does H. pylori cause damage in the stomach?
attracts immune cells and releases enzymes → damage the mucosa → chronic gastritis, ulcers, and atrophy of the antral region
** immune cells → B cell proliferation → possible MALT lymphoma
What is a peptic ulcer and where is it commonly found?
break in the mucosa of the stomach or duodenum caused by acid that extends through the muscularis mucosae
- Most in the duodenum and are solitary with clean, punched-out appearance
What are the symptoms and a major complication of peptic ulcers?
- Symptoms: Burning epigastric pain, worse at night, relieved by food
- Complications: INCREASED ACID production can lead to
ORAL ULCERS or acid- induced irritation
What is autoimmune gastritis and what does it lead to?
auto antibodies against parietal cells or intrinsic factor, leading to
- gland destruction in the body/fundus
- acid loss (achlorhydria)
- vitamin B12 deficiency
What oral problems occur in vitamin B12 deficiency due to autoimmune gastritis?
- caries
- atrophic glossitis
- burning tongue (glossodynia)
- recurrent ulcers
- angular cheilitis
What is gastric adenocarcinoma and where is it most common?
malignant stomach tumor, often in the pylorus and antrum and presents in intestinal or diffuse subtypes
- unfavorable prognosis
- most common in Japan/Korea
What are the growth patterns of gastric adenocarcinoma?
- exophytic (outward)
- flat
- excavated (ulcerated inward)
