Flashcards in Upper gastrointestinal disease Deck (23)
What is chronic gastritis ?
Inflammation of the stomach lining of mucosa
that has lasted for more than 3 months
- can provide an environment in which dysplasia and carcinoma can arise
What are the symptoms of chronic gastritis?
- upper abdominal pain
- indigestion or bloating
- nausea and vomiting
- loss of appetite or weight loss
- however may be asymptomatic
What are the causes of chronic gastritis, A, B C and others.
A - autoimmune disease (normally affect body of the stomach) can lead to pernicious anaemia
B - bacteria (the main is H. pylori)
C - chemical (alcohol, caffeine, tobacco)
Others - psychological stress
helicobacter pylori can affect the eye. What is it ?
lives in the bowel / stomach
- gram-negative microaerophilic bacterium (only needs small amount of oxygen)
- transmitted by faecal-oral route
What are the clinical features of H. pylori?/ what can it cause?
- associated with the development of duodenal ulcers and stomach cancer
- asymptomatic 80%
- peptic ulcer disease
- non-ulcer dyspepsia
- gastric adenocarcinoma
- gastric MALToma / lymphoma
What diseases can H. pylori cause?
- chronic gastritis
- duodenal ulcers
- gastric ulcer
- gastric carcinoma
- gastric MALT lymphoma
What is a peptic ulcer?
a lesion in the lining (mucosa) of the digestive tract
What causes peptic ulcer?
What are the symptoms of peptic ulcer?
- pain (gnawing, burning, aching)
- worse at night
- worse after meals (different to duodenal ulcer which take 2 hours after to meal to have pain)
What are the complications of peptic ulcers?
- bleeding leading to iron deficiency
- massive hematemesis (vomiting of blood)
- perforation leading to peritonitis
- long term cancer at edge of ulcer
What is Barretts oesophagus?
normal lining of the oesophagus stratified squamous epithelium
- in Barretts oesophagus replaced by columnar epithelium with goblet cells
- adaptation due to chronic acid exposure from reflux oesophagitis
- looks like white part instead of pink under microscope
What are the symptoms of Barretts oesophagus?
- can be asymptomatic
- heart burn or indigestion
- nausea or vomiting
- difficultly swallowing
What are the complications of Barretts oesophagus?
- can develop adenocarcinoma of the stomach
What cancers can develop in oesophagus?
- squamous carcinoma (risk factors include alcohol, tobacco, caustic injury, achalasia (damages nerve ends of oesophagus))
What cancers can develop in the stomach?
- GI stromal tumours
What cancers can develop in the small bowel?
- GI stromal tumours
- neuroendocrine tumours
Risk factors of oesophageal carcinoma (squamous cell carcinoma) are alcohol, tobacco, caustic injury and achalasia. What are the symptoms of this?
- weight loss
- respiratory fistula with aspiration
oesophageal carcinoma (adenocarcinoma of the oesophagus) causes symptoms such as dysphagia, weight loss, hematemesis, chest pain and vomiting. What is this largely due to?
- largely from dysplastic change in Barretts oesophagus
Adenocarcinoma of the stomach what are the symptoms of this?
- weight loss
How can adenocarcinoma of the stomach spread?
What is coeliac disease?
- extensive mucosal disease related to sensitivity to gluten.
- can lead to cancer
- auto immune disease
- causes inflammation of the bowel and damage to the villi (leading to malabsorption)
What are the symptoms of coeliac disease?
- pain and discomfort in the digestive tract
- chronic constipation and diarrhoea
- failure to thrive in children
- intestinal damage begins to heal within weeks of gluten being removed from the diet
- Can lead to increased risk of both adenocarcinoma and lymphoma of the small bowel