GI Diseases - Upper GI Flashcards
What cells line the oesophagus?
It is mostly lined by squamous epithilium.
Under the diaphragm it is lined by Glandular Columnar Mucosa
What is Oesophagitis?
Inflammation of the oesophagus.
It can be acute of chronic.
It can be caused by : bacterial viral (HSV1, CMV) fungal (candida) Chemial (acid reflux)
What is the commonest cause / form of oeophagitis?
Reflux Oesophagitis
What are the risk factors of Reflux Oesophagitis?
- Defective Lower Oesophageal Sphincter
- Hiatus Hernia
- Increased Intra Abdo pressure
- Increased gastric fuid volume caused by gastric outflow stenosis.
What are the consequences of Sliding hiatus hernia and Para-Oesophageal hernia?
Sliding hiatus hernia : Reflux Symptoms
Para-Oesophageal Hernia:
Strangulation
What are the complications of reflux oesophagitis?
- Ulceration
- Haemorrhage
- Perforation
- Barrett’s Oesophagus (dysplasia)
- Benign narrowing
What is Barrett’s Oesophagus?
The squamo-columnar junction moves higher up the oesophagus due to long standing reflux.
Can progress to cancer
What are the 2 histological types of oesophageal carcinoma?
1) Squamous Cell Carcinoma
2) AdenoCarcinoma
Where is Oesophageal Adenocarcinoma usually found and how does it look?
-Found in lower oesophagus.
Looks :
-Plaque like, nodular, fungating, ulcerated, depressed.
What is the difference in indicence between Oesphageal adnocarcinoma vs. squamous carcinoma?
Adenocarcinoma:
- industrual countries
- more males affected
- higher amongst caucasians
Squamous Carcinoma:
-wide variation in incidence
What are the 4 anatomical regions of the stomach?
1) Cardia
2) Fundus
3) Body
4) Antrum
What part of the oesophagus is more prone to squamous carcinoma?
Upper 2/3rds
What is gastritis?
Inflammation of lining of stomach
What are the causes of Chronic gastritis?
1) Autoimmune
2) Bacterial infection e.g. H. Pylori
3) Chemical Injury e.g. NSAIDs, Bile reflux
What is H.Pylori
-Gram Negative spiral shaped bacetrium
What does H.Pylori do?
H.Pylori damages the epithelium leading to chronic inflammation of the body,
It can lead to ulcers and cancer.
What part of the stomach does H.Pylori more commonly affect?
Antrum
What are the major sites of peptic ulcer disease?
1) First part of duodenum
2) Junction of antral and body mucosa
3) Distal Oesophagus
What are the main causes of peptic ulcer disease?
1) Hyperacidity
2) H.Pylori Infection
3) Duodenal - gastric reflux
4) Drugs e.g. NSAIDs
5) Smoking
What is the histological definition of an acute gastric ulcer?
It is a full thickness coagulative necrosis of mucosa.
What are the features of a chronic gastric ulcer?
- clear cut edges overhanging base of ulcer.
- Extensive granualtion and scar tissue at floor,
- Scarring
- Bleeding
What are the complications of peptic ulcers?
1) Haemorrhage (can lead to anaemia)
2) Perforation (cause peritionitis)
3) penetration into adjacent organ (e.g. liver)
4) Stricure
What is the most frequent type of Gastric Cancer?
-adenocarcinoma
What are the causes of gastric adenocarcinoma?
- Diet
- H.Pylori
- Bile Reflux
- Hypochlorhydia
What is carcinoma of the gastric-oesophageal junction associated with?
1) Acid reflux
2) No association with H.pylori or diet
3) more common in white males.
What carcinoma of the gastric body/antrum associated with?
- H.Pylori
- Diet (low fruit/veg)
- NO link to acid reflux
What is Coeliac Disease?
It is an immune mediated disease. Causing the intolerance of gluten.
What is the pathogenesis of Coeliac disease?
GLIADIN is a component of gluten that causes epithelial cells to express IL-15.
This causes the activation of CD8+ve T cells. Which attack the cells which have absorbed the gluten.
What are the symptoms of Coeliac?
Anaemia,
Diarrhoea
Bloating
Fatigue
