Upper /gastrointestinal tract disorder:

Question 1

Oesophageal Diverticulum:

Answer 1

• Outpouching of oesophagus
• Food may be trapped
• Can lead to dysphagia & regurgitation
• Occurs in middle → lower oesophagus
• Barrets oesophagus → acid reflux → epithelial changes
  → can lead to cancer

Question 2

Hiatial Hernia:

Answer 2

- Protrusion of upper part of stomach through the 
hiatus (oesophageal opening in the diaphragm) at GI junction 
- Sliding 
-- Congenital short oesophagus 
-- Trauma 
-- Weak diaphragmatic muscles 
--- Coughing 
--- Bending 
--- Tight clothing 
- Paraesophageal
- Greater curvature of stomach herniates alongside 
oesophagus

Question 3

Stomach & Duodenum Alterations:

Answer 3

• Gastritis→inflammation of gastric mucosa
• Acute → superficial erosions
• Chronic→ thinning/degradation of stomach wall
  Causes – non-steroidal anti-inflammatory drugs (aspirin, ibuprofen), coffee, excessive alcohol, injury, burns, stress
  infection
  – H.pylori (90%), autoimmune gastritis

Question 4

Peptic Ulcer:

Answer 4

• Mucosal Ulceration of lower esophagus, stomach or duodenum

Risk factors: Smoking, Alcohol,Cirrhosis, Anti-inflammatory drugs

• Current beliefs
  : Dehydration Vs
  Helicobacter Pylori
• 3 types

Question 5

Duodenal Ulcers:

Answer 5

• most common
• ↑ Gastrin,
• ↑ HCl
• Pain → Stomach empty

Question 6

Gastric Ulcers:

Answer 6

• develop in antrum
• gastric secretion normal or
• ↓ pain after eating
• occurs b/w 55-65 yrs

Question 7

Stress Ulcers

Answer 7

• develop after stress/trauma due to ischemia
• multiple ulceration of stomach and duodenum
  2 types
• Ischemic (develop hrs after haemorrhage)
• Cushing (develop from ↓ blood flow, ↑ HCl production)

Question 8

Peptic ulcers:

Answer 8

Causes
- Traditional beliefs:
Alcohol, acid foods, stress, spicy foods

Question 9

Stomach/Gastric Cancer:

Answer 9

• Ulcers if left untreated – cancer — 60% cases
• Helicobacter pylori
• Run in families = 10%
• Genetic – 1-3% – inherited genetic syndrome – inherit a gene — causes changes in
  E.cadherin gene = often results in stomach cancer.
• Other causes, pickled vegetables, smoking, salt