Gastro-Oesophageal Inflammation and Peptic Ulceration

Question 1

What is Achalasia ?

Answer 1

Increased tone of the lower oesophageal sphincter (LES)

Question 2

What are the 2 ways that cause Achalasia?

Answer 2

Achalasia can be cause by an impairment in the smooth muscle relaxation or by an obstruction

Question 3

What are the 3 rules impairments which make up the Achalasia triad (where if you have any one of these things you have Achalasia)?

Answer 3

Achalasia triad;

• Incomplete lower oesophageal relaxation
• Increased lower oesophageal
• Aperistalisis of the oesophagus (abnormal movement of contraction and relaxation of oesophagus)

Question 4

What causes primary Achalasia?

Answer 4

Primary Achalasiais caused by neuronal or ganglion cell degradation (related to the Vagus nerve). These cases are rare and are usually familial inherited cases

Question 5

What causes secondary Achalasia?

Answer 5

• Chagas disease (Trypanosoma Cruzi infection) causes destruction of myenteric plexuses
• Diabetic autonomic neuropathy (nerve damage) amyloidosis (build up of abnormal protein in body), sarcoidosis (build up of granulomas (inflammation) in body), polio, down syndrome
• Herpes simplex infection

Question 6

What are the 3 treatments for Achalasia?

Answer 6

• Laparoscopic myotomy (incision in muscle cells to relax them)
• Balloon dilation
• Botox injection into smooth muscle cells of oesophagus

Question 7

What is Oesopphagitis?

Answer 7

An infection of the Oesophagus leading to Inflammation

Question 8

What are the causes of Acute Oesophagitis?

Answer 8

An infection in immunocompromised patients;

• Herpes Simplex Virus
• Candida
• Cytomegalovirus

Corrosives

Question 9

What are the causes of Chronic Oesophagitis?

Answer 9

Specific causes;

• Tuberculosis
• Bullous pemiphigoid and epidermolysis bullosa (autoimmune disorders)
• Crohn’s disease

Non Specific Causes;
- Reflux Oesophagitis