Upper GI Flashcards
What is achalasia?
ganglion cells destroyed causing failure of the lower oesophageal sphincter which presents with progressive dysphagia
How should achalasia be investigated?
urgent OGD (often normal)
manometry
How can achalasia be managed?
lots of fluids, eating slowly, ccb and botox
surgery: endoscopic balloon dilatation or myotomy
What is barrett’s oesophagus?
metaplasia of the oesophageal epithelium
What change occurs in barrett’s ?
stratified squamous replaced with columnar, glandular
How does barrett’s present?
GORD
retrosternal pain
belching, odynophagia, cough, hoarseness
How should barrett’s be investigated?
OGD + biopsy
How should barrett’s be managed?
PPI
monitor with repeat endoscopy in low-grade
endoscopic mucosal resection in high-grade
Which type of oesophageal cancer is most common in the UK?
adenocarcinoma
What are the risk factors for oesophageal adenocarcinoma?
GORD
barrett’s
obesity
Which part of the oesophagus is affected by adenocarcinoma?
lower third
What type of oesophageal cancer is more common in the developing world?
squamous cell
What is squamous cell cancer in the oesophagus associated with?
smoking
alcohol
vitamin A deficiency
Which part of the oesophagus is affected by squamous cell carcinoma?
middle and upper thirds
How does oesophageal cancer present?
progressive dysphagia
weight loss
odynophagia
hoarseness
What is the prognosis for oesophageal cancer?
very poor
70% are palliated
What are the 2 presentations of upper GI bleeding?
haematemesis
melena
What is melena?
black tarry smelly stool
Why is melena black
oxidation of iron in the blood as it passes through the ileum and colon
How should ? upper GI bleed be investigated?
urgent OGD
What is Boerhave’s syndrome?
oesophageal rupture causing stomach contents to leak into the mediastinum + pleural space
What causes Boerhave’s?
vomiting
How does Boerhave’s present?
severe sudden retrosternal chest pain
respiratory distress
vomiting
Which blood test is raised in upper GI bleed?
urea
