Gastrointestinal disease Flashcards
What is gasto-oesphageal reflux disease?
Reflux of stomach contents into the oesophagus?
What are the symptoms of gastro-oespahgeal reflux disease?
Heartburn, Cough, Sore throat, Dysphagia
What are the causes of gastro-oesphageal reflux disease?
LOS problems Delays gastric emptying- raise in intragastric pressure Hiatus hernia Obesity
What are the problems with gastro-oesphageal reflux disease?
Oesophagitis Strictures Barretts oesphagus- metaplasia of aquamous epithelium to columnae- Increased risk of adenocarcinoma by 30-40%
What is the treatment for gastro- oesophageal reflux disease?
Lifestyle modification Pharmacological- Antacids, H2 anatogonists, PPIs Surgery
What is acute gastritis?
Acute mucosal inflammatory process
What causes cute gastritis?
Heavy use of NSAIDS Lots of alcohol Chemotherapy Bile reflux
What are the symptoms of acute gastritis?
Asymptomatic or Pain, nausea and vomiting, occasionally bleeding which can be fatal
What is chronic gastritis caused by?
Bacterial due to H-pylori infection
Autoimmune due to antibodies to gastric parietal cells
Chemical reactive due to alcohol, NSAIDS abuse
What are the symptoms of chronic gastritis due to bacteria?
Same as acute gastritis
What may cause other symptoms in chronic gastritis due to bacteria?
Due to complications e.g. pelvic ulcers, adenocarcinoma, MALT lymphoma
What are the symptoms of chronic gastritis due to a autoimmune condition?
Symptoms of anemia, glossitis, anorexia and neurological symptoms
What is peptic ulcer disease?
Defects in gastric/duodenal mucosa which extends through muscularis mucosa
Where does peptic ulcer disease commonly affect?
First part of the duodenum
Lesser curve of the stomach
What causes peptic ulcer disease?
Mucosal injury e.g. stomach acid, H pylori, NSAIDS, smoking and stress- massive physiological stress
They go away and then come back
What are the symptoms of peptic ulcers?
Epigastric pain- back pain sometimes Burning follwing meal times and at night Serious symptoms- bleeding and anemia, satiety, weight loss
What is functional dyspepsia?
have symptoms of ulcer disease but no physical evidence of organic disease
How wold you diagnose gastrointestinal disease?
Upper GI endoscopy and biopsy Urease breath test Erect chest xray- perforation Blood test- anemia
What is the treatment for gastrointestinal disease?
Eradicate H-pylori Triple therapy- PPI and clarithromycin and amoxicillin Stop NSAIDS Endoscopy for bleeding ulcers and dollow up for treated gastric ulvers PPI Pharmacological intervention H2 bockers- cimetidine and ranitidine Proton pump inhibitor omeprazole
How is H pylori spread?
oral or oral or oral to faecal route
What are the characteristics of H pylori?
Helix shaped Gram negative Microaerophilic Has flagellum which gives good motility
What does H pylori do?
produce urease which converts urea to ammonium which increases pH
Where does H pylori live?
In mucus layer and adheres to gastric epithelium
What are the problems with H pylori?
Releases cytotoxins- direct epithelial injury Expresses enzymes like urease and ammonia is toxic to epithelia Degrades mucus layer Promotes inflammatory response- self injury
What happens if H Pylori in the antrum? (g cell home)
duodenal ulceration
What happens if H pylori in the antrum and body?
asymptomatic
What happens if H pylori in body mainly?
Can lead to cancer
What are the symptoms of stress ulceration?
Severe burns, raised intracranial pressure, sepsis, severe trauma, multiple organ failure
What is GORD?
What is gastritis?
What is a peptic ulcer?
What is Zollinger- Ellison?
Pancrease secretes More gastrin
ulcerate stomach and small intestine
What is stomach cancer?
What would pharmacological intervention do?
