CSI 8 Acid Reflux Flashcards
Oesophagus begins at?
inferior border of cricoid cartilage (C6)
Oesophagus ends at?
cardiac orifice of the stomach (T11)
How does oesophagus enter the abdomen?
-through oesophageal hiatus in diaphragm (T10)
Structure of oesophagus?
Adventitia → muscle layer → submucosa → mucosa
Structure and function of upper oesophageal sphincter?
anatomical, striated, between pharynx and oesophagus, constricted to stop air getting in
Structure and function of lower oesophageal sphincter?
physiological/functional, in GOJ, at rest prevents reflux
4 phenomena forming lower oesophageal sphincter?
- oesophagus enters stomach at acute angle
- +ve intra-abdominal pressure so oesophageal wall compressed
- mucosal folds occlude lumen
- pinch cock effect of right crus of diaphragm
4 areas where there are constrictions in oesophageal lumen?
Arch of aorta, Bronchus, Cricoid cartilage, Diaphragmatic hiatus
What is dyspepsia?
recurrent epigastric pain, heartburn or symptoms of acid regurgitation, with or without bloating, nausea or vomiting
How may patients describe dyspepsia?
heartburn, indigestion, chest pain, reflux, tummy ache, bloating
What is reflux?
acidic stomach contents come back up oesophagus towards mouth - can cause feeling of heartburn
What is heartburn?
burning sensation in chest due to acid in stomach - pain felt in chest behind breastbone, may move towards throat
Other symptoms of heartburn and reflux?
unpleasant taste in mouth, swallowing problems
Most common causes of dyspepsia?
functional dyspepsia, gastritis, GORD, peptic ulcer disease
What is functional dyspepsia?
individual symptoms of dyspepsia but no causative abnormalities in investigations
What is gastritis?
inflammation of gastric mucosa
Potential causes of gastritis?
infection, medications like NSAIDs (affecting integrity of stomach’s mucous lining) or alcohol excess
What can severe cases of gastritis lead to?
ulceration
What is GORD?
gastro-oesophageal reflux disease → reflux of gastric contents
GORD can cause?
oesophagitis (due to irritation)
What are some additional symptoms of GORD alongside dyspepsia?
belching, water brush (excessive salivation in mouth), discomfort worse after eating and on lying down, burning pain behind sternum
What does peptic ulcer disease refer to?
gastric ulceration or duodenal ulceration
What is an ulcer?
sore on lining of stomach or duodenum
What are some less likely causes of dyspepsia?
- coeliac disease
- inflammatory bowel disease
- pancreatitis
- medication side effects
- gallbladder disease
- gastroenteritis