BARRETT'S OESOPHAGUS Flashcards
1
Q
WHAT IS THE PATHOPHYSIOLOGY OF BARRETT’S OESOPHAGUS?
A
- metaplasia of oesophageal epithelial lining, from stratified squamous epithelium to simple columnar epithelium.
2
Q
WHICH REGION OF THE OESOPHAGUS IS COMMONLY AFFECTED?
A
- distal oesophagus
3
Q
WHAT IS THE CAUSE OF BARRETT’S OESOPHAGUS?
A
- caused by chronic GORD damaging epithelium
4
Q
WHAT ARE THE RISK FACTORS FOR BARRETT’S OESOPHAGUS?
A
- Caucasians
- male
- > 50 years old
- age
- smoking
- obesity
- hiatus hernia
- FH Barrett’s oesophagus
5
Q
WHAT ARE THE CLINICAL FEATUERS OF BARRETT’S OESOPHAGUS?
A
- history of chronic GORD
- retrosternal chest pain
- excessive belching
- odynophagia
- chronic cough and hoarseness
6
Q
WHAT IS THE MALIGNANCY RED FLAGS?
A
- dysphagia
- weight loss
- loss of appetite
- malaise
- worsening dysphagia despite PPI treatment
7
Q
WHAT ARE INVESTIGATIONS FOR BARRETT’S OESOPHAGUS?
A
1) OGD and biopsy of oesophageal epithelium
8
Q
WHAT WILL OGD SHOW?
A
- red and velvety
9
Q
WHAT IS THE MANAGEMENT FOR BARRETT’S OESOPHAGUS?
A
1) PPI - high dose and twice daily
2) NSAIDs cessation as it disrupts stomach barrier
10
Q
WHAT IS THE LIFESTYLE MANAGEMENT FOR BARRETT’S OESOPHAGUS?
A
- stop smoking
- no alcohol
- low fat diet
- weight loss
11
Q
WHAT IS THE COMPLICATION FOR BARRETT’S OESOPHAGUS?
A
- progression to adenocarcinoma
12
Q
WHAT DO PATIENTS WITH CONFIRMED BARRETT’S OESOPHAGUS UNDERGO?
A
- regular endoscopy
13
Q
HOW IS HIGH GRADE DYSPALSIA TREATED AND WHY?
A
- endoscopic mucosal resection
- endoscopic submucosal dissection
- due to high chance of progression to cancer
