A guide to upper GI pathology

Question 1

GORD?

Answer 1

gastro-oesophageal reflux disease

Question 2

2 broad categories of GORD?

Question 3

Symptoms of GORD?

Answer 3

• heartburn (an uncomfortable burning sensation in the chest that often occurs after eating)
• acid reflux (where stomach acid comes back up into your mouth and causes an unpleasant, sour taste)
• oesophagitis (a sore, inflamed oesophagus)
• bad breath
• bloating and belching
• feeling or being sick
• pain when swallowing and/or difficulty swallowing

Question 4

What is GORD?

Answer 4

common condition, where acid from the stomach leaks up into the oesophagus (gullet).

It usually occurs as a result of the ring of muscle at the bottom of the oesophagus becoming weakened.

Question 5

Tx for GORD?

Answer 5

Proton pump inhibitor - omeprazole and lansoprazole

• gavascon or rennie (Alaska line in stomach)

They may recommend medicines called antacids or alginates that can help ease your symptoms.

Question 6

Proton pump inhibitor examples?

Answer 6

Omeprazole

Lansoprazole

Question 7

Barrett’s oesophagus?

Answer 7

condition where some of the cells in your oesophagus grow abnormally.

Pre-cancer condition

Question 8

Medication for barret’s oesophagus?

Answer 8

Proton pump inhibitors

Metaprozole and lansoprazole

Question 9

How often to do an endoscopy for barret’s oesophagus?

Answer 9

Every 5 years

Question 10

Peptic disease?

Answer 10

a condition that occurs when the stomach or the first part of the small intestine develops a sore in its lining.

This can happen due to gastric acid secretion or pepsin.

Question 11

Symptoms of peptic disease?

Answer 11

Abdominal discomfort or pain.
Nausea.
Pain radiating to the back (which could indicate the ulcer has penetrated)
Burning or gnawing feeling similar to hunger pains.
Pain aggravated by meals (may suggest gastric ulcers)
Pain relieved by meals (may suggest duodenal ulcers) - benign

Question 12

Tx for peptic disease?

Answer 12

Antibiotics for HP
Proton pump inhibitors
Antacids

Question 13

HP?

Answer 13

Helicobacter Pylori bacteria

Question 14

What is H. Pylori negatively associated with?

Answer 14

GORD

Question 15

What is the relationship between H. Pylori and GORD?

Answer 15

NEGATIVE

Question 16

What can h. Pylori cause?

Answer 16

peptic ulcer disease and gastritis (inflamed stomach lining)

Cause chronic gastritis
- atrophied gastritis (impaired acid production)
- antral gastritis (increased acid production)

Question 17

Symptoms of h. Pylori?

Answer 17

Symptoms include dull or burning stomach pain, unplanned weight loss and bloody vomit.

Question 18

Tx for H. Pylori?

Answer 18

antibiotics (amoxicillin) and

proton pump inhibitors (metaprozole)

Question 19

What type of cancer is oesophageal cancer?

Answer 19

Squamous cel carcinoma to barret’s disease to Adenocarcinoma

Question 20

Symptoms of oesophageal cancer?

Answer 20

having problems swallowing (dysphagia)
feeling or being sick
heartburn or acid reflux
symptoms of indigestion, such as burping a lot

Question 21

Gastric adenocarcinoma?

Answer 21

the most common type of stomach cancer, accounting for 95% of all stomach cancers in the UK. It develops in the glandular cells of the stomach lining

Question 22

Symptoms of gastric adenocarcinoma?

Answer 22

Swelling or fluid build-up in the abdomen, Blood in the stool, Feeling tired or weak, and Yellowing of the skin and eyes

Often diagnosed late as early symptoms are vague and not specific to cancer

Question 23

What disease can HP cause?

Answer 23

Peptic disease

Question 24

Immunoglobulin involved in coeliac disease?

Answer 24

IgA

Question 25

What is coeliac disease?

Answer 25

a chronic autoimmune disorder that occurs when the immune system attacks the small intestine in response to gluten

In coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

This damages the surface of the small bowel (intestines), disrupting the body’s ability to take in nutrients from food.

It’s not entirely clear what causes the immune system to act this way, but a combination of genetics and the environment appear to play a part.

T lymphocytes

Damages barrier in small intestine - damage small intestine

Question 26

Villi in coeliac disease?

Answer 26

Flat villi and malabsorption

Question 27

Symptoms of coeliac disease?

Answer 27

diarrhoea, which may smell particularly unpleasant
stomach aches
bloating and farting (flatulence)
indigestion
constipation

Question 28

Tx for coeliac disease?

Answer 28

Avoid gluten

Question 29

What happens if you keep eating gluten and have coeliac disease?

Answer 29

weakening of the bones (osteoporosis)
iron deficiency anaemia
vitamin B12 or folate deficiency anaemia

Even bowel cancer (lymphoma)

Question 30

Symptoms of Crohn’s?

Answer 30

diarrhoea
stomach aches and cramps
blood in your poo
tiredness (fatigue)
weight loss

Question 31

What is chron’s disease?

Answer 31

lifelong condition where parts of the digestive system become inflamed.

IBD

Question 32

Types of IBD?

Answer 32

Crohn’s disease and ulcerative colitis

Question 33

Who is more likely to have oesophageal candiditis?

Answer 33

Immune compromised e.g. HIV

Or use steroid inhaler

Question 34

Tx of oesophageal candida?

Answer 34

Antifungal
Fluconazole

Question 35

Topical sprue?

Answer 35

rare digestive disease that impairs the small intestine’s ability to absorb nutrients. It’s characterized by chronic diarrhea, weight loss, and nutritional deficiencies

Flat villi = malabsorption