Oesophageal Diseases Flashcards
Which type of cancer is typically present in the lower 1/3 of the oesophagus?
Adenocarcinoma
What does adenocarconima in the oesophagus typically arise from?
Barrett’s Oesophagus
What are the 2 types of cancer that can arise in the oesophagus?
Squamous carcinoma
Adenocarcinoma
Why is prognosis for oesophageal cancer so poor?
Because it is relatively asymptomatic until late presentation
What are the main alarm symptoms of presenting oesophageal cancer?
DYSPHAGIA Weight loss Anorexia Chest pain Hoarse voice
What investigations need to be carried out in oesophageal cancer?
Upper GI endoscopy
Barium swallowing
CT - staging
Endosocopic Ultrasound
What is Barrett’s oesophagus?
Consequence of GORD
Acid causes a change from squamous epithelium to glandular epithelium in the oesophagus
Dysplasia which can lea to metaplasia
Predisposition for cancer
What is a palliative treatment for oesophageal cancer?
Endoscopic stenting
What are the requirements for the surgical resection of oesophageal cancer?
Need to be fit for surgery (consider age)
No metastases
Pre-op chemotherapy
Is heartburn common?
Yes
What is GORD disease?
Recurrent reflux of gastric acid into the oesophagus
What are the symptoms of GORD?
Heartburn - recurrent
Dysphagia
Nocturnal cough
Chest pain
What are the investigations for GORD?
Endoscopy
24 hour ABPM pH monitoring
What is the Pathology of GORD?
Oesphagus is not designed to cope with an acidic environment
Oesophagitis
Endoscopic change
Scarring and ulceration
What is a potential consequence of GORD that can be a predisposition to cancer?
Barrett’s oesophagus
What is the patient required to do during 24 hours ABPM pH monitoring?
Record a symptom diary
What is the treatment for GORD?
Anti-acids
PPI
H2 antagnosits
Endoscopic surveillance for dysplasia
Why does GORD require endoscopic surveillance?
To monitor for barrett’s oesophagus
And dysplasia
What is a hiatus hernia?
When part of the stomach protrudes into the oesophagus
What are the symptoms of a hiatus hernia similar to that of?
GORD
What is the treatment for hiatus hernia?
Essentially the same as treatment for GORD
How long is the oesophagus?
Approximately 25cm long