A guide to upper GI pathology Flashcards
GORD?
gastro-oesophageal reflux disease
2 broad categories of GORD?
Symptoms of GORD?
- 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
What is GORD?
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.
Tx for GORD?
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.
Proton pump inhibitor examples?
Omeprazole
Lansoprazole
Barrett’s oesophagus?
condition where some of the cells in your oesophagus grow abnormally.
Pre-cancer condition
Medication for barret’s oesophagus?
Proton pump inhibitors
Metaprozole and lansoprazole
How often to do an endoscopy for barret’s oesophagus?
Every 5 years
Peptic disease?
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.
Symptoms of peptic disease?
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
Tx for peptic disease?
Antibiotics for HP
Proton pump inhibitors
Antacids
HP?
Helicobacter Pylori bacteria
What is H. Pylori negatively associated with?
GORD
What is the relationship between H. Pylori and GORD?
NEGATIVE
What can h. Pylori cause?
peptic ulcer disease and gastritis (inflamed stomach lining)
Cause chronic gastritis
- atrophied gastritis (impaired acid production)
- antral gastritis (increased acid production)
Symptoms of h. Pylori?
Symptoms include dull or burning stomach pain, unplanned weight loss and bloody vomit.
Tx for H. Pylori?
antibiotics (amoxicillin) and
proton pump inhibitors (metaprozole)
What type of cancer is oesophageal cancer?
Squamous cel carcinoma to barret’s disease to Adenocarcinoma
Symptoms of oesophageal cancer?
having problems swallowing (dysphagia)
feeling or being sick
heartburn or acid reflux
symptoms of indigestion, such as burping a lot
Gastric adenocarcinoma?
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
Symptoms of gastric adenocarcinoma?
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
What disease can HP cause?
Peptic disease
Immunoglobulin involved in coeliac disease?
IgA
What is coeliac disease?
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
Villi in coeliac disease?
Flat villi and malabsorption
Symptoms of coeliac disease?
diarrhoea, which may smell particularly unpleasant
stomach aches
bloating and farting (flatulence)
indigestion
constipation
Tx for coeliac disease?
Avoid gluten
What happens if you keep eating gluten and have coeliac disease?
weakening of the bones (osteoporosis)
iron deficiency anaemia
vitamin B12 or folate deficiency anaemia
Even bowel cancer (lymphoma)
Symptoms of Crohn’s?
diarrhoea
stomach aches and cramps
blood in your poo
tiredness (fatigue)
weight loss
What is chron’s disease?
lifelong condition where parts of the digestive system become inflamed.
IBD
Types of IBD?
Crohn’s disease and ulcerative colitis
Who is more likely to have oesophageal candiditis?
Immune compromised e.g. HIV
Or use steroid inhaler
Tx of oesophageal candida?
Antifungal
Fluconazole
Topical sprue?
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
