Week 2 Pre-Learning: GI Tract - GERD, Hiatal Hernia, Esophageal Cancer

Question 1

What are some complications that may occur in the upper GI? (6)

Answer 1

• GERD
• Hiatal Hernia
• GI Bleeding
• Esophageal cancer
• Peptic ulcer disease (PUD)
• Gastritis

Question 2

What is gastroesophageal reflux disease (GERD)?

Answer 2

• a condition where gastric contents move into the esophagus, creating the sensation of heartburn and/or esophagitis

Question 3

What can GERD be caused by? (5)

Answer 3

• weak of incompetent lower esophageal sphincter
• Hiatal hernia
• Impaired esophageal motility
• Increased abdominal pressure
• Delayed gastric emptying

Question 4

What are two common symptoms of GERD?

Answer 4

• heartburn (pyrosis)
• Regurgitation

Question 5

What is pyrosis? (3)

Answer 5

• heartburn
• Burning/tight sensation felt intermittently beneath lower sternum and spread to throat/jaw
• occurs 30-60 mins after meal and worse when bending at night

Question 6

What is regurgitation? (2)

Answer 6

• Effortless return of gastric contents
• Often described as hot bitter or sour liquid

Question 7

What are respiratory symptoms of GERD?

Answer 7

• aspiration of stomach contents can can cause wheezing, coughing, and dyspnea

Question 8

What are chronic complications of GERD? (3)

Answer 8

With ongoing esophagitis:
1) Ulceration and bleeding
2) Esophageal structure: narrowing of esophagus caused by scar tissue formation (leads to dysphagis)
3) Barrett’s esophagus

Question 9

What is Barrett’s esophagus? (2)

Answer 9

• replacement of esophageal stratified squamous epithelium with simple columnar epithelium (like stomach/intestine)
• 10% of patients with Barrett’s will develop esophageal cancer

Question 10

What is a hiatal hernia?

Answer 10

• Herniation of a portion of the stomach into the esophagus through an opening in the diaphragm

Question 11

What are the contributing factors to developing a hiatal hernia? (2)

Answer 11

• weakening in the diaphragm around esophogastric opening
• increase in intra-abdominal pressure (obesity, pregnancy, ascites, tumours, heavy lifting)

Question 12

What are symptoms of a hiatal hernia? (2)

Answer 12

• similar to GERD
• often occur when supine, after a large meal, and with smoking/alcohol

usually detected through imaging

Question 13

What are the symptoms of esophageal cancer? (6)

Answer 13

• asymptomatic (early)
• Dysphagia (first with meat, then soft foods, then liquids)
• Neck pain
• sore throat
• Weight loss
• bleeding (complication)