Pathology of the Upper GI Tract Flashcards
What structures make up the upper GI tract?
Oesophagus, stomach and duodenum
What can happen to the oesophagus if it is experiencing constant acid reflux?
- Thickening of the epithelium (first response)
- Ulceration
- Barrett’s oesophagus
- Stricture due to healing by fibrosis
What is Barrett’s oesophagus?
Transformation of the epithelium in the oesophagus from stratified squamous to glandular
Pre-malignant condition
Which type of oesophageal cancer develops from Barrett’s oesophagus?
Adenocarcinoma
Local effects of oesophageal cancer?
Obstruction
Ulceration
Perforation
What is one way in which fatigue can be caused by oesophageal cancer?
If there has been an ulceration/perforation due to the cancer there may be bleeding - which can cause anaemia and therefore fatigue
What is the prognosis for oesophageal cancer like?
Very poor
5 year survival < 15%
3 Classes of gastritis causes?
Autoimmune (type A) Bacterial (type B) Chemical injury (type C)
What is gastritis?
Inflammation of the protective lining of the stomach, can be chronic or acute
Effect of autoimmune gastritis?
Immune cells attack specialized gastric acid secreting cells (parietal cells)
Loss of gastric epithelium - less acid secretion and loss of intrinsic factor (-pernicious anaemia)
Most common type of gastritis?
Bacterial gastritis
Which bacteria is commonly a cause of gastritis?
Helicobacter pylori
How does the stomach respond to bacterial gastritis infection?
Increases acid production Inflammatory response (can be a chronic or acute response)
Common causes of chemical gastritis?
Alcohol
Bile reflux from duodenum
NSAIDs
Common cause of peptic ulceration?
H. pylori infection
due to increased gastric acid
Why does peptic ulceration occur? Parts of body that can be affected?
Imbalance between acid secretion and mucosal barrier secretion (too much acid/too little mucous)
Lower oesophagus, body and antrum of stomach, first and second parts of duodenum)
Complications of peptic ulceration?
Bleeding (acute haemorrhage/chronic - anaemia)
Perforation - peritonitis
Fibrosis - obstruction
What can increase likelihood of gastric cancer?
Previous H. Pylori infection
How can stomach cancer spread?
Direct (surrounding tissues)
Lymphatic
Blood
Transcoelomic (within peritoneal cavity)
Prognosis of stomach cancer?
Poor
5 year survival <20%
