Stomach pathology Flashcards
(41 cards)
What does dyspepsia mean?
describes a complex of upper GI symptoms which present for 4 or more weeks
What symptoms are included?
heart burn, coughing, sore throat (acid damages), dysphagia, nausea and vomiting
What are some common gastric disorders?
GORD Gastritis Peptic ulcer disease Zollinger-ellison disease -Stress ulcers -Cancer
What is GORD?
where the stomach contents moves into the oesophagus
What are the symptoms of GORD?
chest pain, acid taste in mouth, cough
What are the consequences of GORD?
nothing
- oesophagitis
- strictures
- barrets oesophague (metaplasia of stratified squamous to simple columnar)
What can trigger GORD?
- obesity (increased abdominal pressure)
- pregnancy (new or worsened cases)
- hiatus hernia (cardia of stomach moves into thorax reducing basal tone) HIGH RISK OF REFLUX OESOPHAGITIS
- LOS function
- delayed gastric emptying (increase in intra-gastric pressure)
What does the LOS consist of?
- muscles
- right crus of diaphragm
- oblique entry of oesophagus into stomach
- intra abdominal pressure
What is the treatment for GORD?
lifestyle modification (eat too fast/large meals/eat before bed)
pharmacological
-antacids (form layer of there acid)
-H2 antagonists (prevents histamine activating parietal cells)
-proton pump
surgery (RARE)
What is gastritis?
inflammation of the stomach (can be acute or chronic)
What are the of acute symptoms?
asymptomatic OR pain, nausea, vomiting, bleeding
-need to do endoscopy to see inflammation
What causes acute gastritis?
- acute mucosal inflammatory processes
- heavy use of NSAIDs
- lots of alcohol
- chemotherapy
- bile reflux
Why does chemical injury cause inflammation?
exposure of mucosa to chemical injury causes damages to epithelial cells so less mucus is produced and the mucose responds by vasodilation and appearance of inflammatory cells (neutrophils)
What is the treatment for acute gastritis?
removal of the irritant
What causes chronic gastritis?
- bacterial (H.pylori infection)
- autoimmune (antibodies to gastric parietal calles can lead to pernicious anaemia
What is pernicious anaemia?
a deficiency in the production of RBC due to lack of vitamin D
How does helicobacter-pylori cause inflammation?
- releases cytotoxins which directly injure the epithelia
- expresses enzymes that form urease causing ammonium production which is toxic (converts urea to ammonium)
How can you get h-pylori?
spread via oral to oral transmission or faecal to oral speak - has a flagellum to aids in motility
-also lives in mucus layer and adores to the gastric epithelia
What type of bacteria is h-pylori?
helix shaped
gram negative
What symptoms does someone with chronic gastritis caused by bacteria cause?
- asymptomatic or similar to acute gastritis
- symptoms may develop due to complications (peptic ulcers, adenocarcinoma, MALT lymphoma)
What occurs if H-pylori if found in the antrum (where G cells are) ?
there is increased gastrin secretion so increase parietal cell acid secretion - causes duodenal epithelial metaplasia and colonisation of duodenum causing a duodenal ulcer
What occurs if H-pylori is found in the antrum and body?
asymtpomatic
What occurs if H-pylori is found in the body?
-causes atrophy, gastric ulcer leading to intestinal metaplasia which can lead to dysplasia and then cancer
How is H-pylori diagnosed?
- urea breath test
- stool antigen test