GI Flashcards
What are some causes of GORD?
Hiatus hernia, obesity, gastric acid hyper secretion, delayed gastric emptying, smoking, alcohol
How does GORD present?
Oesophagus - heartburn, belching, acid brash, water brash
Extra-oesophagus - nocturnal asthma, chronic cough, laryngitis, sinusitis
How is GORD diagnosed?
Endoscopy if dysphagia, 24h oesophageal pH monitoring
How is GORD managed?
Lifestyle - weight loss, smoking cessation, small, regular meals
Drugs - antacids
Surgery
What is a peptic ulcer?
A break in the inner lining of the stomach, first part of the small intestine or sometimes the lower oesphagus
Describe the pathology of peptic ulceration
Inflammation caused by the bacteria H. pylori, or erosion from stomach acids
How do peptic ulcers present?
Epigastric pain often related to hunger, specific foods or time of day, ‘heart burn’, tender epigastrium
Alarm symptoms - anaemia, weight loss, anorexia, haematemesis
How do gastric/duodenal ulcers present and get diagnosed?
Asymptomatic, epigastric pain, weight loss
Upper GI endoscopy, test for H.pylori
How are peptic ulcers managed?
Lifestyle: decrease alcohol and tobacco use
H.pylori eradication
Drugs to reduce acid - proton pump inhibitors
Stop taking drugs causing drug-induced ulcers
What are oesophago-gastric varices?
Submucosal venous dilatations secondary to high portal pressures.
What are the causes of oesophago-gastric varices?
Cirrhosis, thrombosis, parasitic infection
What are the risk factors for oesophago-gastric variceal bleeds?
High portal pressure, variceal size, advanced liver disease
How do oesophago-gastric varices present?
Only symptomatic if they bleed; vomit blood, bloody stools, light headedness, loss of consciousness in severe cases
How can oesophago-gastric varices be prevented?
Don’t drink alcohol, healthy diet and weight, reduce risk of hepatitis
How are oesophago-gastric varices managed?
Endoscopic banding or sclerotherapy
What is haematemesis?
Vomiting blood
What is melaena?
Black motions, often like tar, and has a characteristic smell of altered blood
What is a Mallory-Weiss tear?
A tear in the mucous membrane where the oesophagus meets the stomach
What are the symptoms of a Mallory-Weiss tear and how are they managed?
Persistent vomiting causes haematemesis via the tear.
Endoscopy to stop the bleeding
What is gastritis?
Inflammation of the lining of the stomach
What are the causes of gastritis?
Irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin.
Helicobacter pylori, bile reflux, infections caused by bacteria and viruses
What are the risk factors for gastritis?
Alcohol, NSAIDs, H.pylori, reflux hernia
How does gastritis present?
Epigastric pain, vomiting, indigestion, abdominal bloating
How is gastritis diagnosed?
Upper GI endoscopy, blood tests (anaemia/ H.pylori), faecal occult blood tests