Pathology of the upper GI tract Flashcards
What is the definition of upper GI tract pathologies?
Diseases of the upper GI tract which cause upper abdominal or retrosternal discomfort or pain or “indigestion”
What are the 3 structures located in the upper GI tract?
oesophagus, stomach and duodenum
What causes oesophageal reflux?
gastric acid refux into the oesophagus
What is a common cause of oesophageal reflux?
hiatus hernia
What happens to the epithelium in oesophageal reflux?
the non keratinising stratified squamous epithelium is thickened
How is the effects of oesophageal reflux repaired and what are the consequences of this?
fibrosis (scar tissue)
obstruct the oesophagus and can impair motility
What is barrett’s oesophagus?
The changing of epithelium in the oesophagus to a premalignant simple columnar glandular epithelium
metaplasia
What are the 2 types of oesophageal cancer and which is barrett’s oesophagus linked to?
squamous carcinoma
adenocarcinoma - BO
What is oesophageal cancer linked to?
diet and environment and is on the rise
What are the risk factors for oesophageal squamous carcinoma?
smoking, diet, alcohol
What is adenocarcinoma of oesophagus risk factors?
barrett’s oesophagus and obesity
Why is obesity a risk factor for oesophageal adenocarcinoma?
pro inflammatory environment
can cause hiatus hernia
What is the prognosis for oesophageal cancer?
very poor
less than 15% 5YS
What are the local effects of oesophageal cancer and also their effects?
obstruction - decreased nutrition as hard to eat
ulceration - blood loss as vessels exposed
perforation - causes abscess
What are the 3 possible means of oesophageal cancer spread?
blood - liver
lymphatics
direct
What is gastritis?
inflammation of the mucosa of the stomach
What are the 3 types of gastritis?
autoimmune, bacterial, chemical injury
What happens to gastric acid secretion in autoimmune gastritis?
decreased along with intrinsic factor as atrophy and loss of gastric epithelium cells
autoantibodies for parietal cells
What bacteria is bacterial gastritis linked to?
H. Pylori
What type of bacteria is H. Pylori, what is its effects and where is it found and treated?
gram negative found in the gastric mucus
increases acid production
antibiotics
What kinds of things can cause chemical injury gastritis?
NSAIDS, alcohol, bile reflux
What is the aetiology of peptic ulceration?
imbalance in the acid secretion and mucosal bacteria
What parts of the GI tract does peptic ulceration effect?
lower part of oesophagus
body and antrum of stomach
1st and 2nd part of duodenum
What is peptic ulceration associated with as a cause?
H. Pylori as increased acid production
What are some complications of peptic ulceration?
bleeding, perforation and fibrosis
What are acute and chronic bleeding called?
haemorrhage
anaemia
What can perforation of a peptic ulcer cause?
peritonitis
What is stomach cancer linked to a previous infection of?
H. Pylori
What type of cancerous cells are found in gastric cancer?
adenocarcinoma as cancer of glandular cells
What is an additional way of spread in stomach cancer compared to oesophageal cancer?
transcoelomic spread into the peritoneal cavity which travels to the pelvis
What is the prognosis of stomach cancer?
very poor - less than 20% 5YS
