05.1 Gastric Disease

Question 1

What is GORD?

Answer 1

Gastro oesophageal reflux disease - the contents of the stomach reflux into the oesophagus.

Question 2

What are the symptoms of GORD?

Answer 2

Heartburn
Cough
Sore throat
Pain on swallowing

Question 3

What are potential causes of GORD?

Answer 3

Lower oesophageal sphincter problems
Delayed gastric emptying
Hiatus hernia
Obesity

Question 4

What problems can GORD cause?

Answer 4

Oesophagitis
Strictures
Barrett’s oesophagus - Metaplasia - Adenocarcinoma

Question 5

What lifestyle changes can treat GORD?

Answer 5

Smaller, spaced out meals

Question 6

What are some pharmacological treatments of GORD?

Answer 6

Antacids
H2 antagonist
PPIs

Question 7

What is acute gastritis and what can cause it?

Answer 7

It is an acute mucosal inflammatory process.

In can be cause by - Heavy NSAIDs use, alcohol, chemotherapy and bile reflux.

Question 8

Name an NSAID.

Answer 8

Ibuprofen

Aspirin

Question 9

What are common symptoms of acute gastritis?

Answer 9

A symptomatic
Pain, nausea, vomiting
Bleeding

Question 10

What are some causes of chronic gastritis?

Answer 10

H Pylori
Autoimmune disease of parietal cells
Chronic abuse of the acute causes (alcohol/NSAIDs)

Question 11

What are symptoms of H Pylori?

Answer 11

Asymptomatic which leads to

Peptic ulcers and adenocarcinoma

Question 12

What are the symptoms of autoimmune disease of parietal cells?

Answer 12

Anaemia
Glossitis
Anorexia
Neurological symptoms

Question 13

Where is the most common place for a peptic ulcer to form?

Answer 13

1st part of the duodenum.

Question 14

What must the ulcer extend through to be classed as peptic ulcer disease?

Answer 14

The muscularis mucosa of the duodenum or stomach.

Question 15

Where is the most common place for a gastric ulcer to occur?

Answer 15

Small curve of the stomach.

Question 16

What can cause peptic ulcer disease?

Answer 16

Stomach acid
H Pylori
NSAIDs
Smoking

Question 17

What are the symptoms of peptic ulcer disease?

Answer 17

Epigastric pain (burning, following meals and at night)
Bleeding
Satiety
Weight loss

Question 18

What are some diagnostic methods for gastric pathology and what are they used for?

Answer 18

Upper GI endoscopy - biopsies
Urease breath test - positive for H Pylori
Chest X Ray - check for perforation
Blood test - check for anaemia

Question 19

How do you treat H Pylori?

Answer 19

PPI
Clarithromycin
Amoxicillin

Question 20

Name some H2 blockers?

Answer 20

Cimetidine

Ranitidine

Question 21

What is a common PPI?

Answer 21

Omeprazole.

Question 22

What happens if H Pylori is located primarily in the antrum?

Answer 22

Increased G cell proliferation - more acid

This can lead to duodenal ulceration

Question 23

What happens if H Pylori is located primarily in the body of the stomach?

Answer 23

Has an atrophic effect.

This leads to gastric ulceration.

Question 24

What is Zonllinger Ellison syndrome and what does it lead to?

Answer 24

Gastrin secreting tumour of the pancreas, this leads to proliferation of parietal cells causing increased acid production and can lead to severe ulceration.

Question 25

What can cause stress ulceration?

Answer 25

Increased intracranial pressure
Burns
Sepsis
Severe trauma
Multiple organ failure

Question 26

How does stomach cancer present?

Answer 26

Dysphagia
Loss of appetite
Malaena
Weight loss
Nausea/vomiting
Virchow's nodes

Question 27

What is dyspepsia?

Answer 27

Difficulty of ingestion due to upper GI symptoms.