GI diseases

Question 1

what are the main gi diseaes?

Answer 1

oesophagus and peptic ulcer disease
malabsorption
-pernicious anaemia
-coeliac disease
-crohn's disease
large bowel
-IBC
-crohns/ulcerative colitis
-colonic ca
-infections

Question 2

what medicines are used in upper GI disease?

Answer 2

antacids
-eliminate formed acid
reduce acid secretion
-H2 receptor blockers
-proton pump inhibitors

Question 3

how do antacids work?

Answer 3

alkali

-forms salt with gastric acid -> neutralised effect on tissue

Question 4

describe stomach acid production

Answer 4

by parietal cell
triggers parietal cells
-acetylcholine
-gastrin
-histamine
proton pump inhibitor works irrespective of trigger

Question 5

what do H2 receptor agonists do?

Answer 5

reduce acid production by preventing histamine activation of acid production
-limited benefit as alternative pathways still operative

Question 6

give 2 examples of H2 receptor agonists and evaluate

Answer 6

cimetidine
-many drug interactions
-not fully effective
ranitidine
-not any more effective
-safer clinically
OTC

Question 7

give examples of proton pump inhibitors

Answer 7

omeprazole
lansoprazole
pantoprazole

Question 8

describe endoscopy

Answer 8

scope into stomach, duodenum and small parts of bowel

can carry forceps to biopsy, and cautery

Question 9

what is capsule endoscopy?

Answer 9

swallow capsule
camera
transmits photos to reciever

Question 10

what is dysphagia?

Answer 10

difficulty swallowing

Question 11

what can cause dysphagia?

Answer 11

external compression
-oesophagus next to other structures
-any swelling/lump will compress oesophagus
lung/aorta/atrial enlargement/cervical spine

Question 12

what are (2) dysmotility disorders?

Answer 12

fibrosis
-loss of muscle tissue
-unable to stretch/propel food
-scleroderma
-acid related fibrosis (GORD)
neuromuscular dysfunction
-nerve control of muscle lost
-parkinsons
-diabetes
-achalasia

Question 13

what is dysphagia?

Answer 13

food sticking
-intermittent or constant
localised well by px
may be functional
may be dysmotility
may be external compression

Question 14

what is GORD

Answer 14

gastro-oesophageal reflux disease

heartburn

Question 15

what are the 3 main causes of GORD?

Answer 15

defective lower oesophageal sphincter
-shuts oesophagus off from gastric contents
impaired lower clearing
-emptying into stomach
impaired gastric emptying
-goes back into oesophagus

Question 16

what effects can GORD have?

Answer 16

ulceration
inflammation
metaplasia
barrett's oesphagitis
-if GORD persists change in epithelium occurs
-precancerous: adenocarcinoma

Question 17

what are the signs & symptoms of GORD?

Answer 17

epigastric burning
-worse lying down, bending, pregnancy
dysphagia
-oesophagitis, stricture, dysmotility
GI bleeding
severe pain
-oesophageal muscle spasm

Question 18

what is hiatus hernia?

Answer 18

part of stomach is in thorax
symptoms similar to GORD
-easier for gastric contents to pass into oesophagus and cause symptoms of reflux
more common in women

Question 19

how is GORD managed?

Answer 19

stop smoking
-improved sphincter
lose weight
avoid triggering activity
antacids
H2 blockers & PPI's
-ranitidine & omeprazole
increase GI motility & gastric emptying