1.2. Oesophageal Disease - Barrett's Oesophagus Flashcards
What is the cause of Barrett’s Oesophagus?
This is a late-stage continuation of Gastro-Oesophageal Reflux Disease (GORD)
What is the Pathology of Barrett’s Oesophagus?
- The Oesophageal Mucosa are chronically exposed to Gastric Acid / Pepsin
- Metaplasia of the Oesophageal Mucosa occurs
What does the Mucosa change from / to?
From - Stratified Squamous Epithelium
To - Mucin-Secreting Columnar Epithelium
Where, other than in the Oesophageal Mucosa in Barrett’s Oesophagus, can Mucin-Secreting Columnar Epithelium be found?
These Cells can be seen in the Epithelium of the Cells which line the Stomach
What is the Purpose of the Metaplasia?
To try and prevent the Oesophagus from further injury
What are the Clinical Signs of Barrett’s Oesophagus?
- Increased Oesophageal pH
2. Oesophageal Mucosal Metaplasia
What symptoms would a patient with Barrett’s Oesophagus present with?
- Heart Burn
- Regurgitation
- Cough
- Water-Brash
- Sleep Disturbances
What causes the feeling of “Heartburn”?
The actions of Gastric Acid and Pepsin on the Oesophageal Mucosa
What causes the “Regurgitation”?
The Weakened Lower Oesophageal Sphincter
When would “Rregurgitation” occur most often in Barrett’s Oesophagus?
When lying flat
What causes the “Cough”?
Due to the Body’s natural response to any potential Aspiration of Gastric Contents
What is “Water Brash”?
The Over-Production of Saliva in the Oral Cavity
Why does “Water Brash” occur?
It is an action of the Mouth to try and Dilute and Counteract the effect the Gastric Contents are having on the Oesophageal Mucosa
What investigations are Required in Barrett’s Oesophagus?
- Upper G.I. Endoscopy with Biopsy
2. 24-hour pH monitoring with Manometry
What is the purpose of the Upper G.I. Endoscopy and Biopsy?
- To assess the extent of Metaplasia in the Oesophagus
2. To look for signs of Dysplasia
