Stomach diseases Flashcards
What is Gastroparesis
a motility disorder associated with delayed gastric emptying of solid food without mechanical obstruction
What are the possible causes of Gastroparesis (3)
diabetes
Neurological conditions
Connective tissue conditions
Post-surgery
Medications
Idiopathic
What are the symptoms of Gastroparesis (3)
upper abdominal pain
Postprandial fullness
Nausea and vomiting
What investigations are used for Gastroparesis (2)
OGD
Gastric emptying studies
What methods are used to treat gastroparesis (7)
dietary modifications
Glycemic control
Cessation of aggravating medications
Pro-kinetics
Neuromodulators
Gastric pacemaker
Venting gastronomy
What does GORD refer to
a spectrum of diseases producing symptoms of heart burn and acid regurgitation due to retrograde movements of gastric contents from the stomach to the oesophagus
What is the pathophysiology of GORD (4)
Anti reflux barriers decrease
Gastric acid secretion occurs
Duodenogastric reflux occurs
Gastric emptying is delayed
What anti-reflux barriers normally exist (3)
lower oesophageal sphincter tone
Oesophageal acid clearance
Tissue resistance
What are the risk factors for GORD (3 lifestyle 3 others)
Obesity
Smoking
Alcohol
Genetics
Hiatus hernia
Pregnancy
How can GORD present
asymptomatic
Heart burn
Regurgitations
Odonyphagia
Burping, hiccups
Nausea/vomiting
Cough
Hoarseness
Chest pain
What are signs of GORD (4)
haematemesis/Melaena
Dysphagia
Weight loss
Persistent vomiting
What investigations can be used for GORD (2)
OGD
H/pylori breath test/stool antigen test
What methods of treatment can be used for GORD (5)
Lifestyle modifications
Anti acids/alginates
PPI
H2 receptor antagonist
H.pylori eradication
What is a significant complication that can arise due to GORD
barret’s oesophagus
What are the types of chronic gastritis (3)
Autoimmune
H.pylori associated
Chemical
Describe the changes that occur in autoimmune gastritis (4)
Loss of gastric parietal cells
Gastric atrophy
Intestinal Metaplasia
Inflammation
What deficiencies is autoimmune gastritis associated with (2)
macrocytic anaemia
B12 deficiency
What complications are linked with H.pylori associated gastritis
Ulceration
Atrophy
Intestinal Metaplasia
Gastric cancer
MALT lymphoma
Describe chemical gastritis (3)
Injury to mucous layer by fat solvents
Leads to epithelial regeneration, hyperplasia, and congestions
Can lead to erosions and ulcers
What can contribute to chemical gastritis (3)
NSAIDs
Alcohol
Bile reflux
Which type of gastritis involves minimal inflammation
Chemical gastritis
What is a peptic ulcer
a breach in mucosa due to injury by acid or pepsin
How does H.pylori contribute to pathology of peptic ulcers
Increases gastric secretion > increased delivery of hydrogen ions to the duodenum
Reduces bicarbonate production if directly in the duodenum
How do NSAIDs contribute to the pathology of peptic ulcers
inhibit COX1 and COX2
Decreases prostaglandin production
Increase risk of mucosal erosion
What are common sites for peptic ulcers (4)
1st part of duodenum
Junction between body and antrum of stomach
Stomach near surgical connection or anastomosis
Gastro-oesophageal junction
What are complications of peptic ulcers (4)
perforation
Haemorrhage
Stenosis
Pain
What types of benign gastric tumours exist (2)
Hyperplastic polyps
Cystic fundi gland polyps
What types of malignant gastric tumour exist (3)
carcinomas (Adenocarcinoma)
Lymphoma
GIST
Describe the aetiology of gastric Adenocarcinoma
H.pylori infection > chronic gastritis > gastric atrophy > intestinal Metaplasia > dysplasia > adenocarcinoma
What are the types of gastric adenocarcinoma (4)
diffuse type
Intestinal type
Mixed
Undifferentiated
Describe diffuse type gastric adenocarcinoma
a tumour that infiltrates and expands the stomach wall rather than growing as a discrete tumour
Describe gastric lymphomas
Continuous inflammation induces evolution into clonal B cell proliferation
Can evolve into high grade B cell lymphoma if untreated
Describe GIST tumours (2)
gastrointestinal stroma tumours derived from gut pacemaker cells
What investigations are done for gastric tumours (4)
endoscopy
CT chest abdomen and pelvis
CT PET
Laparoscopy
What treatments are used for gastric tumours (3)
endoscopic resection (of mucosa/submucosa)
Endoscopic-guided radiofrequency ablation
Gastrectomy with D2 lymphadenectomy (subtotal/total)
