Stomach General Flashcards
What is the main bacteria in the stomach?
Atleast 40% population is H.Pylori
Population and type of bacteria in the small intestine
Low numbers of bacteria and mainly aciduric bacteria: Lactobacilli, Streptococci and Yeasts
What is special about the bacteria in the SI?
They can survive the acidity of the stomach
What is the type and population of bacteria in the LI?
- Dense population
- Mainly anaerobes (obligate)
What is the one of the main issues with the large intestine being complex?
The microbiota is poorly studied
How do bacteria lead to diarrhea?
- Bacterial toxins lead to increased water and electrolytes being secreted into the intestine
- Bacteria cause mucosal injury leading to inflammation and impaired absorption
Name 4 common bacterial enteric pathogens
Campylobacter, Salmonella, E.Coli and S.aureus
3 main symptoms of Gastroenteritis
- Vomiting
- Diarreha (With or withour blood) +Mucous
- Abdominal pain+Distention
Most common bacterial cause of Gasteroenteritis
Campybolcater
Source of campybolacter
Undercooked food
How many organisms needed for campybolacter
Low infective dose
Which bacteria causes disease in travellers
E.coli (Toxigenic)
What are the symptoms of GI disease
Flatluence, Diarrhea, Steattorhea, Vomiting, Dysphagia, Dyspepsia,Heartburn, Constipation, Abdominal pain
What is steatorrhea and in what disease is it seen?
Fat coming out in the stool due to fat malabsorption. Seen in Coeliacs
What are the symptoms linked to oeseophageal symptoms
Dysphagia, Vomiting/Cough and Pain
What are the 2 muscles which meet at Kilians dehisience
Thryopharyngeus and Cricopharyngeus
What can Kilians dehisience lead to?
Zenkers diverticulum (herniation of mucosa)
What can the causes of dysphagia be divided into:
Extrinsic pressure =goitre , Intrinsic lesions= pharyngeal pouch , Neuromuscular=Myasthenia gravis and motility disorder= achalasia
How do we rule out cardiac pathology linked to dysphagiaa?
Cardic enzymes and EEG
Symptoms of pharyngeal pouch?
Dysphagia and swelling in lower neck usuallly on left
Cause of pharyngeal pouch?
Herniation in the mucosa due to weakness in pharyngeal constrictor muscles
What is achalasia?
Loss of ganglia from intramural plexus so we dont get relaxation of gastro-oesophageal sphincter, so oesophagus dilates as food builds up in it as we dont get peristalsis.
What is oesphophageal spasm?
Attacks of dysphagia and pain.
Variety of causes: Motor disorders or systematic peristalsis or GORD
What is scary about Oesophageal web
It is premalginant
Symptoms in oesophageal web
Dysphagia, Koilonychia, Iron deficiency Anaemia, Glossitis
What is the oesophageal web?
Fibrous stricture which forms at upper end of oesophagus due to atrophy of mucosa
What happens in peptic ulcer disease/Reflux
Failure of cardiac sphincter to relax so we get acid refulx into oesophagus
Symptoms of peptic ulcer
Pain, Ulcer and spasm
AETIOLOGy of peptic ulcer
Destruction of lining mucosa due to acid and pepsin (causes inflammation)
4 reasons lining mucosa is damaged
H/pylori
Smoking
Steroids
Aspirin and NSAIDs
What happens in Barretts oesophagus
Due to acid repeatedly going from stomach to oesophagus, there is metaplasia of the oesophageal cels into Gastric lining cells.
Pre-malignant
Where can carcinoma of oesophagus spread
-lymph nodes
liver
-fungate into lumen of oesopagus
-infiltrate adjacent structures such as mediastinum
