05.1 Gastric Disease Flashcards
What is GORD?
Gastro oesophageal reflux disease - the contents of the stomach reflux into the oesophagus.
What are the symptoms of GORD?
Heartburn
Cough
Sore throat
Pain on swallowing
What are potential causes of GORD?
Lower oesophageal sphincter problems
Delayed gastric emptying
Hiatus hernia
Obesity
What problems can GORD cause?
Oesophagitis
Strictures
Barrett’s oesophagus - Metaplasia - Adenocarcinoma
What lifestyle changes can treat GORD?
Smaller, spaced out meals
What are some pharmacological treatments of GORD?
Antacids
H2 antagonist
PPIs
What is acute gastritis and what can cause it?
It is an acute mucosal inflammatory process.
In can be cause by - Heavy NSAIDs use, alcohol, chemotherapy and bile reflux.
Name an NSAID.
Ibuprofen
Aspirin
What are common symptoms of acute gastritis?
A symptomatic
Pain, nausea, vomiting
Bleeding
What are some causes of chronic gastritis?
H Pylori
Autoimmune disease of parietal cells
Chronic abuse of the acute causes (alcohol/NSAIDs)
What are symptoms of H Pylori?
Asymptomatic which leads to
Peptic ulcers and adenocarcinoma
What are the symptoms of autoimmune disease of parietal cells?
Anaemia
Glossitis
Anorexia
Neurological symptoms
Where is the most common place for a peptic ulcer to form?
1st part of the duodenum.
What must the ulcer extend through to be classed as peptic ulcer disease?
The muscularis mucosa of the duodenum or stomach.
Where is the most common place for a gastric ulcer to occur?
Small curve of the stomach.
What can cause peptic ulcer disease?
Stomach acid
H Pylori
NSAIDs
Smoking
What are the symptoms of peptic ulcer disease?
Epigastric pain (burning, following meals and at night)
Bleeding
Satiety
Weight loss
What are some diagnostic methods for gastric pathology and what are they used for?
Upper GI endoscopy - biopsies
Urease breath test - positive for H Pylori
Chest X Ray - check for perforation
Blood test - check for anaemia
How do you treat H Pylori?
PPI
Clarithromycin
Amoxicillin
Name some H2 blockers?
Cimetidine
Ranitidine
What is a common PPI?
Omeprazole.
What happens if H Pylori is located primarily in the antrum?
Increased G cell proliferation - more acid
This can lead to duodenal ulceration
What happens if H Pylori is located primarily in the body of the stomach?
Has an atrophic effect.
This leads to gastric ulceration.
What is Zonllinger Ellison syndrome and what does it lead to?
Gastrin secreting tumour of the pancreas, this leads to proliferation of parietal cells causing increased acid production and can lead to severe ulceration.
What can cause stress ulceration?
Increased intracranial pressure Burns Sepsis Severe trauma Multiple organ failure
How does stomach cancer present?
Dysphagia Loss of appetite Malaena Weight loss Nausea/vomiting Virchow's nodes
What is dyspepsia?
Difficulty of ingestion due to upper GI symptoms.
