Upper GI Flashcards
Dyspepsia
- typical duration of the disease?
- symptoms?
- common cause?
- life style management?
- treatment?
- 4 / more weeks
- upper GI pain / discomfort, heartburn, acid reflux, N&V
- GORD, peptic ulcer disease, functional dyspepsia, malignancy, Barrett’s oesophagus
- Weight management, avoid trigger food, eat smaller meals, stop smoking & reduce alcohol intake
- 1 month PPI
medications that can exacerate dyspepsia ?
alpha-blockers
anticholinergics
aspirin
benzodiazepines
beta-blockers
CCB
corticosteroids
nitrates
NSAIDS
theophyllines
tricyclic antidepressants
What is the common cause of ulcers
H.pylori
Explain what condition is can be?
- how is this cause from?
- What is this predisposes to ?
- colour when doing an endoscopy?
- what is the consequence of this condition from?
Barrett’s oesophagus
- normal squamous convert to columnar metaplasia
- development of oesophageal adenocarcinoma
- salmon to red in colour
- erosive oesophagitis
GORD
- What is this disease?
- symptoms
- complciations
- causes
- Lower oesophageal sphincter weakens or abnormally relaxes
- heartburn and regurgitation, asthma, chronic cough & laryngitis
- erosive oesophagitis, Barrett’s oesophagus and oesophageal carcinoma
- pressure abnormalities, impaired oesophageal acid, delayed gastric emptying, hiatus hernia, impaired mucosal resistance
Achalasia
- definition
- S&S
- Diagnosis
- treatment
- primary motility disorder which involves the smooth muscle layer of the oesophagus and the lower oesophageal sphincter(LOS)
- chest pain, cough, loss of weight, dysphagia, regurgitation and reflux of food and liquids, Odynophagia (pain when swallowing)
- Upper GI endoscopy
barium swallow
oesophageal manometry (gold standard) - Pneumatic dilatation
Peroral endoscopic myotomy (POEM)
Surgical myotomy
Oesophagitis
- common cause
- types
- symptoms
- treatment
- GORD
- infection (oesophageal candidiasis)
corrosives (bleach / battery acid)
Drugs
eosinophilic oesophagitis (common in children & young adults) - dysphagia, heartburn, chest pain and vomiting
- corticosteroids
Upper GI bleed
- symptoms
- types of GI bleed
- Haematemesis, melaena, ‘coffee-ground’ emesis
- oesophageal varices, peptic ulcer, gastritis
Oesophageal varices
- what is it
- presentation
- Treatment
- typically cause from
- Dilated veins in the distal oesophagus or proximal stomachcaused by elevated pressure in the portal venous system
- asymptomatic until haematemesis
- endoscopic banding and IV octreotide + beta blockers
- liver cirrhosis (portal hypertension)
Mallory Weiss Tear
- what is it?
- what are the likelihood factors of the tear?
- mucosal tear in the oesophagus at the gastro-oesophageal junction
- history of alcohol intake + vomiting with blood
oesophageal cancer
- types
- most common?
- Area affected of cancer?
- symptoms?
- risk factors?
- management ?
- treatment?
- squamous cells carcinoma (SCC)
Adenocarcinoma - related to Barrett’s oesophagus - adenocarcinoma
- SCC (upper and middle oesophagus)
adenocarcinoma (lower oesophagus & esophagogastric junction) - dysphagia, persistent dyspepsia, vomiting, weight loss, epigastric pain
- Age, obesity, Hiatus hernia, smoking, GORD/B. oesophagus/achalasia
- urgent upper gastrointestinal endoscopy
- Endoscopic therapy, surgery, radio, chemo, palliative care
what’s the different of management guidelines for oesophageal and stomach cancer?
Consider non-urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer in people with haematemesis.
What is the requirement for urgent direct access upper gastrointestinal endoscopy
with dysphagia
age 55
weight loss
upper abdo pain
refulx
dyspepsia
differences of gastric and duodenal ulcers
gastric:
food aggravates pain
vomiting common
more likely haematemesis
hyposecretion of gastric acid
Duodenal
food relieve pain
less common vomiting
melena
hypersecretion gastric acids
