Oesophageal Reflux, Cancer and Gastritis Flashcards
What is the most common symptom associated with upper GI pathology?
Upper abdominal pain /Retrosternal pain/indigestion
What are the potential consequences of oesophageal reflux? (3)
Thickening of squamous epithelium
Ulceration of oesophagus in severe reflux
Barret’s oesophagus
If the damage done by oesophageal reflux heals by fibrosis, what can occur? (3)
Stricture formation
Impaired oesophageal motility
Oesophageal obstruction
What is Barrett’s oesophagus? (3)
A type of metaplasia
Change from squamous to glandular epithelium in the oesophagus
A pre-malignant condition
What are the two main histological types of oesophageal cancer?
Squamous carcinoma
Adenocarcinoma
What are the risk factors for squamous oesophageal cancer? (3)
Smoking
Alcohol
Dietary carcinogens
What are the risk factors for adenocarcinoma oesophageal cancer? (2)
Barrett’s metaplasia (oesophageal reflux)
Obesity
What are the local effects of oesophageal cancer? (3)
Obstruction
Ulceration
Perforation
Where may oesophageal cancer spread to? (3)
Invasion of local structures
Regional lymph nodes
Liver through bloodstream
What are the three types of gastritis?
Autoimmune
Bacterial
Chemical
What autoantibodies are produced in type A gastritis?
Against parietal cells and intrinsic factor
What are the consequences of type A gastritis? (2)
Decreased acid secretion
Loss of intrinsic factor (Vit. B12 deficiency)
Which bacteria is most commonly involved in type B gastritis?
H. pylori
Which chemicals are commonly involved in type C gastritis? (3)
Drugs (esp. NSAIDs)
Bile
Alcohol
What is gastritis?
Inflammation of the gastric mucosa
What vertebral level does the oesophagus start?
C6
What vertebral level is the oesophageal hiatus?
T10
What cranial nerve mediates contraction of the oesophagus and opening of the LOS?
Vagus
What investigations may be performed for oesophageal disorders? (5)
UGIE Oesophago-gastro-duodenoscopy (OGD) Barium swallow Oesophageal pH (reflux) Manometry
What are common associated symptoms of heartburn? (2)
Cough
Waterbrash
What food and drugs can lead to reflux? (3)
Alcohol
Nicotine
Dietary Xanthine
What should you ask about in a history of dysphagia? (4)
Type of foods solid or liquid)
Pattern (progressive or intermittent)
Associated Symptoms (weight loss, regurgitation, cough)
Location (oropharyngealor oesophageal)
Describe a hypermotile oesophagus during barium swalllow
Corkscrew like appearance
What is the treatment for a hypermotile oesophagus
Smooth muscle relaxants
What diseases are associated with a hypomotile oesophagus (3)
Connective tissue disease
Diabetes
Neuropathy
What is achalasia? (2)
Functional loss of myenteric plexus ganglion cells i the distal oesophagus and LOS
Absence of useful peristaltic contractions in the lower oesophagus
What are the symptoms of achalasia? (4)
Progressive dysphagia
Weight loss
Chest pain
Regurgitation and chest infection
What are the complications of achalasia?
Aspiration pneumonia
Lung disease
Increased risk of squamous cell oesophageal carcinoma
What are the pharmacological treatments for achalasia? (2)
Nitrates
Calcium channel blockers
What are the endoscopic treatments for achalasia? (2)
Botulin toxin
Pneumatic balloon dilation
What is the surgical treatment for achalasia?
Myotomy
