Oesphagus (GIT) Flashcards
Define dyspepsia, dysphagia and odonophagia.
Dyspepsia = heartburn, indigestion Dysphagia = difficulty swallowing Odonophagia = painful swallowing
What are some complications of upper GI disease?
Mucosal ulceration
Fistulae between organs
Eosion of wall with extravasation of gastro-oesophageal contents
Erosion of vessels leading to haemorrhage
How do oesophageal varices form and what is the most common reason for them?
Oesophageal varices = dilated veines caused by portal HTN (increased resistance to blood flow through portal venous system + liver).
Most common caused by liver cirrhosis from alcohol misuses.
Define GORD
Gastro-oesophageal reflux disease = symptoms that occur at least once a week.
Acid reflux = sensation of acid in oesophagus + dyspepsia. Often made worse after eating or lying down.
What causes GORD
Inadequacy of the lower oesophageal sphincter.
Relaxation of the LoS allows acid to rise up. Mediated by VAGAL pathway.
Can be caused by gastric distension or increase in abdominal pressure (eating, pregnancy).
What is hiatus hernia?
When the stomach bulges up through an opening in the diaphragm. Can cause GORD.
What are the morphological consequences of GORD?
Reflux can cause chronic inflammation, leading to cellular injury/adaptation:
Intestinal metaplasia of oesophagus = Barrett’s oesophagus (severe GORD)
Dysplasia –> carcinoma
Describe the definition and morphology of Barrett’s oesophagus.
Chronic inflammation leads to oesophageal squamous mucosa to undergo metaplasia into intestinal epithelium.
Morphology
Macroscopic - tongues of red, velvety mucosa extending upwards from GOJ
Microscopic - intestinal metaplasia (columnar cells, goblet cells)
What is the name for inflammation of the oesophagus that is immune-mediated?
What is the macroscopic hallmark of this?
Eosinophilic oesophagitis.
ASsociated with atopic disease (rhinitis, asthma, dermatitis) and can be caused by food allergens.
Causes RINGS on the inside of the oesophagus.
Is eosinophilic oesophagitis associated with risk of Barrett’s oesophagus?
No!
What are the two main types of oesophageal carcinomas?
Adenocarcinoma
Squamous cell carcinoma
How common are oesophageal cancers?
Not very.
Which oesophageal cancer is associated with a background of chronic GORD and Barrett’s oesophagus?
Besides these, list two risk factors and one protective factor.
Adenocarcinoma.
Also more common in men, and smokers.
Gastric atrophy is protective against adenocarcinoma
Inspection of the oesophagus shows pale, white plaques growing into ulcerating masses.
Microscopic inspection shows squamous differentiation.
What is this?
What are hte risk factors.
Oesophageal squamous cell cancer.
Most airse due to alcohl and tobacco use, most commonly in males.
Pale, white plaques.
