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Flashcards in Upper gastrointestinal disease Deck (23)
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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
- belching
- 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?

h. pylori


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))

- adenocarcinoma


What cancers can develop in the stomach?

- adenocarcinoma
- GI stromal tumours


What cancers can develop in the small bowel?

- lymphoma
- 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
- haemorrhage
- sepsis
- 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
- anorexia
- anaemia
- haemorrhage


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
- anaemia
- fatigue
- 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


How is coeliac disease diagnosed?

via serological blood test (TTG) and biopsy