Upper GI Flashcards
Gastroesophageal Reflux Disease (GERD)
-reflux of stomach content
causes troublesome symptoms and/or complications
-Chest pain, Cough
Throat clearing, Sore throat
Hoarseness, Globus
-Dx: Empiric trial of acid suppression, abnormal pH study, erosive esophagitis, Barrett’s esophagus, peptic stricture
-Upper endoscopy
GERD management
-PPI: 30-60 min before meals (omeprazole (Prilosec, Prilosec OTC, Zegerid)
lansoprazole (Prevacid)
pantoprazole (Protonix)
rabeprazole (Aciphex)
esomeprazole (Nexium)
dexlansoprazole (Dexilant)
-Histamine 2 blockers (Famotidine (Pepcid AC, Pepcid Oral, Zantac 360)
Cimetidine (Tagamet, Tagamet HB)
Nizatidine Capsules)
-Surgery option
-HOB elevation
-Tobacco cessation
-Wt loss
-Avoid eating before laying down
Barrett’s Esophagus
Esophageal squamous epithelial lining replaced by columnar epithelium extending ≥ 1cm above the gastroesophageal junction AND histological evidence of specialized IM
Achalasia
Myenteric plexus degeneration resulting in aperistalsis and failure of the lower esophageal sphincter relaxation
Scleroderma
-diseases that involve the hardening and tightening of the skin. It may also cause problems in the blood vessels, internal organs and digestive tract
-Rheumatology and GI consult
-LES-wide open and relaxed
Mallory-Weiss Tear
-Long tears in the distal esophagus/proximal stomach. Found with forceful retching . Submucosal arteries bleed
-Hematemesis with epigastric or back pain
-Suspect with upper GI bleed and history of retching
-EGD
Peptic Ulcer Disease (PUD)
-Causes: Helicobactor pylori: Duodenal ulcer>Gastric. NSAIDs: Gastric ulcer>Duodenal ulcer
-Dyspepsia-burning, hunger pain, epigastric, affected by food and antacids
-Dx: Endoscopy, upper GI barium less sensitive
Hiatal Hernia
Herniation of abdominal contents through esophageal hiatus
-Most asymptomatic
GERD symptoms
Dysphagia
Early satiety
-Surgical repair for selected patients
GERD treatment
Gastritis
-Inflammation with mucosal injury
-Diagnosed by EGD with biopsy
Celiacs
-Immune disorder triggered by gliadin component of gluten
-Inflammatory state of small bowel