Upper GIT

Question 1

what are the components of the upper GIT? 6

Answer 1

oral cavity
salivary glands
pharynx
oesophagus
stomach
duodenum

Question 2

what are the symptoms of GI disease? 6

Answer 2

Pain
dysphagia - difficulty swallowing
dyspepsia - discomfort related to upper GIT (heartburn, pain, acidity)
heartburn
regurgitation
odynophagia- pain when swallowing

Question 3

what 2 ways are used to visualise the upper GI tract?

Answer 3

radiological investigation
endoscopy

Question 4

what is a radiological investigation

Answer 4

barium is swallowed and radiographs are taken following the progress of the barium through the upper GIT

Question 5

what is an endoscopy?

Answer 5

direct visualisation of the GIT and permits biopsies of areas of concern during the examination

Question 6

name 3 upper GI disorders

Answer 6

gastro-oesophageal reflux disease (GORD)
hiatus hernia
peptic ulcer disease

Question 7

what is gastro-oesophageal reflux disease (GORD)?

Answer 7

complication from the reflux of gastric contents into the oesophagus or beyond into the oral cavity

Question 8

what causes gastro-oesophageal reflux disease (GORD)?

Answer 8

excess acid at the Lowe oesophageal sphincter

Question 9

what is hiatus hernia?

Answer 9

a segment of the stomach lies above the diaphragm
may reduce lower oesophageal sphincter pressure
leading to reflux of acid

Question 10

general symptoms of gastro-oesophageal reflux disease 2

Answer 10

heartburn
regurgitation

Question 11

oral symptoms of gastro-oesophageal reflux disease 5

Answer 11

dental erosion
globus - feeling of lump in throat
unpleasant taste
halitosis
burning sensation

Question 12

how is gastro-oesophageal reflux disease manages?

Answer 12

lifestyle changes
proton pump inhibitors - PPI
antacids

Question 13

examples of PPIs have what at the end of their names?

Answer 13

prazole

Question 14

what are the oral side effects of PPIs 3

Answer 14

dry mouth - common
altered taste - rare
stomatitis - rare

Question 15

when is omeprazole prescribed by the dentist?

Answer 15

when NSAIDs (ibuprofen) are being prescribed for patients with a past history of upper GI disease

Question 16

name the 2 types of antacids

Answer 16

aluminium hydroxide based e.g. rennies
alginate based e.g. gaviscon

Question 17

what are the complications of GORD? 7

Answer 17

Barrett’s oesophagus
Adenocarcinoma
Stricture
Ulceration
Haemorrhage
Anaemia
Aspiration pneumonia

Question 18

what is peptic ulcer disease?

Answer 18

gastric and/or duodenal ulceration that penetrates the muscolaris mucosa exposing the submucosa

Question 19

what is an ulcer?

Answer 19

a breach in the epithelium

Question 20

what causes peptic ulcer disease?

Answer 20

H. pylori
NSAIDs

Question 21

what are the symptoms of peptic ulcer disease? 5

Answer 21

epigastric pain
dyspepsia
vomiting
loss of appetite
sensation of bloating

Question 22

what investigations are used if peptic ulcer disease is suspected? 3

Answer 22

upper GI endoscopy
determine if H.Pylori is present (e.g. breast test, biopsy)

Question 23

what is the treatment for acute peptic ulcer disease?

Answer 23

endoscopy
rarely surgery

Question 24

what is the treatment for non-acute peptic ulcer disease?

Answer 24

acid suppression - PPI
treat H.Pylori with PPI and antibiotics

Question 25

what are the 3 dental considerations of upper GI disease?

Answer 25

safe prescribing side effects of medical management oral manifestations of the disease

Question 26

what things should we be cautious of when prescribing NSAIDs?

Answer 26

older patients in the presence of upper GI disease symptoms with corticosteroids

Question 27

name 2 side effects of PPIs

Answer 27

dry mouth - common altered taste - rare

Question 28

what are the side effects of H2 receptor antagonist? 2

Answer 28

dry mouth altered taste - uncommon

Question 29

what are the secondary symptoms of upper GI disease?

Answer 29

Aphthous lesion Angular cheilitis Oral candidiasis Glossitis burning sensation in the mouth