Gastro - Dysphagia/oesophageal Issues

Question 1

Treatment for Barrett’s oesophagus without dysplasia and with dysplasia

Answer 1

Without dysplasia - PPI
With dysplasia (low or high grade) - endoscopic ablation.

Question 2

Risk factors for Barrett’s oesophagus

Answer 2

Men
Had reflux symptoms >5 years
Nocturnal reflux symptoms
Hiatus hernia
Elevated BMI
Tobacco use
Intra abdominal distribution of fat

Question 3

Frequency of follow up for Barrett’s oesophagus

Answer 3

BE with no dysplasia - between 3-5 years, but if long segment >3cm - 2-3 years time. If indeterminate - repeat in 6 months with Seattle protocol.
BE with low grade dysplasia and not wanting ablation - 6 monthly to ensure no adenocarcinoma.
High grade dysplasia - refer for surgery/intervention.

Question 4

Most common infectious causes in descending order of oesophagitis.

Answer 4

1. Candida albicans
2. Cmv
3. Hsv

Question 5

Most common pill induced causes of oesophagitis

Answer 5

Nsaids, potassium chloride, iron, alendronate, tetracycline