Upper GI disease

Question 1

What is the difference between the oedema in Ulcerative Colitis and Chron’s?

Answer 1

Ulcerative colitis oedema is superficial.

Chron’s oedema goes through the entire bowel wall.

Question 2

How do you get rid of Helicobacter Pylori?

Answer 2

Triple therapy - 2 antibiotics - amoxicillin and metronidazole, and 1 proton pump inhibitor - omeprazole.

Question 3

Complications of PUD

Answer 3

• Anaemia - SYSTEMIC - caused by low-level peptic ulcer that goes on for months - loss of haemoglobin.
  LOCAL
• Perforation - can cause peritonitis
• Haemorrhage - erosion of ulcer into blood vessel - bleeds into stomach. Vomiting - brown and granular
• Stricture - chronic irritation and inflammation - SCAR that contracts and reduces size of exit from stomach.
• Malignancy - due to recurring disease and healing.

Question 4

Mouth problems caused by medication for IBD?

Answer 4

NSAIDs can cause mouth ulcers

Immunosuppressants for IBD - can exacerbate/ increase risk for periodontitis

Question 5

Side-effect of acid in oesophagus from PUD?

Answer 5

BARRET’S OESOPHAGUS - cells change from squamous to columnar (stomach cells). METAPLASIA - risk of cancer.

Question 6

What drugs can you NOT give to someone with PUD?

Answer 6

Ibuprofen = NSAID. Exacerbates condition.

Question 7

Signs of Coeliac in children and adults

Answer 7

Children - stinted growth, ulcers

Adults - may be NOTHING. Mouth ulcers, nutritional deficiencies (iron and folic acid).

Question 8

Why do you get oedema in Chron’s?

Answer 8

INFLAMMATORY REACTION
Lymphocytes throughout bowel wall.
LARGE MULTI-NUCLEATED GIANT CELLS cause obstruction to the bowel wall so lymph is unable to drain out through the lymphatic system, causing oedema.
Fibrous bands between oedema cause Chron’s mucosa to appear KNOBBLY.

Question 9

Symptoms of Ulc. Col?

Answer 9

Diarrhoea
Abdominal pain
PR bleeding

Question 10

Symptoms of Chron’s?

Answer 10

Same as ulc. col. for chron's of LI.
SI
Pain
Malabsorption
Obstruction - pain and discomfort and sometimes vomiting
OROFACIAL GRANULOMATOSIS