Disorders of the Oesophagus Flashcards
What is Barrett’s oesophagus?
the metaplasia of lower oesophageal squamous epithelium to gastric columnar epithelium
what is metaplasia?
reversible change from one differentiated cell type to another
what is Barrett’s oesophagus usually caused by?
chronic acid exposure as a result of malfunctioning lower oesophageal sphincter
what does the acid in Barrett’s oesophagus do?
the acid irritates the oesophageal epithelium, leading to a metaplastic change
what is the most common symptom of Barrett’s oesophagus?
long-term burning sensation of indigestion
how can Barrett’s oesophagus be detected?
via endoscopy of the oesophagus
what are patients found with Barrett’s oesophagus monitored for?
any cancerous changes
what are the clinical features of Oesophageal carcinoma?
- dysphagia
2. weight loss
what is dysphagia?
difficulty swallowing
when and how does dysphagia become worse?
dysphagia becomes progressively worse over time as the tumour increases in size, restricting the passage of food
what are the 2 major types of oesophageal carcinomas?
squamous cell carcinoma and adenocarcinoma
what is squamous cell carcinoma?
the most common subtype of oesophagus cancer
where can squamous cell carcinoma occur in the oesophagus?
at any level of the oesophagus
what does adenocarcinoma occur?
in the inferior 1/3 of the oesophagus
what is adenocarcinoma associated with?
Barrett’s oesophagus
where does adenocarcinoma normally originate?
in the metaplastic epithelium of Barretts’ oesophagus
What are oesophageal varices?
abnormally dilated sub-mucosal veins (in the wall of the oesophagus) that lie within this anastomosis
when are oesophageal varices usually produced?
when the pressure in the portal system increases beyond normal
what is portal hypertension?
when the pressure in the portal system increases beyond normal
when does portal hypertension most commonly occur?
secondary to chronic liver disease e.g. cirrhosis or an obstruction in the portal vein
what are varices predisposed to?
bleeding, with most patients presenting with haematemesis
what is haematemesis?
vomiting of blood
which group of people are at a high risk of developing oesophageal varices?
alcoholics
