Upper GI Flashcards
What organs are in the upper GI tract?
Oesophagus
Stomach
Intestine.
What is chronic gastritis?
Persistant inflammation of the stomach.
Compared to acute gastritis symptoms are less severe but last longer
Can cause dysplasia and carcinoma.
What are the symptoms of chronic gastritis?
Upper abdominal pain. Indigestion or bloating Nausea or vomiting Loss of appetite or weight loss. However can be asymptomatic.
What causes chronic gastritis?
A- Autoimmune, causing pernicious anaemia.
B- Bacterial- Helicobacter pylori
Chemical- Alcohol, tobacco and caffeine.
Explain helicobactar pylori
Bacteria that causes chronic gastritis.
Gram negative bacteria found in the stomach, particularly antrum.
Over half of the world population is affected by age 5.
Transmitted faecal-orally.
Linked with the development of duodenal ulcers and stomach cancer.
What is the presence of H. pylori?
80% asymptomatic. 5-15% PUD 10% non ulcer dyspepsia. 1-3% gastric adenocarcinoma. 0.5% gastric MALToma.
What diseases is H. pylori connected to?
Chronic gasritis Duodenal ulcer. Gastric ulcer gastric carcinoma MALT lymphoma.
What are the effects of a H. pylori infection?
Body predominant- hypochlorhydira, gastric atrophy, intestinal metaplasia.
Antrum predominant infection- hyperchlorhydria.
Where do peptic ulcers originate and what are their symptoms?
PUD usually occurs in the D1 or antrum.
Commonly caused by H pylori and NSAIDs.
Ulcers are usually solitary.
Symptoms include burning and aching- symptoms worse at night or after meals.
What are some of the complications of peptic ulcers.
Prolonged bleeding leading to anaemic iron deficiency.
Massive haematemesis
Perforation leading to peritonitis.
Cancer at the edge of the ulcer.
What is Barrett’s oesophagus.
When normal stratified squamous is replaced by columnar epithelium with goblet cells.
This is an adaptation from exposure to acid.
An example of metaplasia.
Can cause dysplasia- low grade invasive carcinoma and oesophageal adenocarcinoma.
What are examples of oesophagus cancer? (UGIs)
Squamous carcinomas.
Adenocarcinoma (barretts)
What are examples of stomach cancer
Adenocarcinoma
GIST- GI stromal tumours.
What are examples of small bowel cancer?
Lymphoma
GIST
Neuroendocrine tumours.
Explain squamous carcinoma.
Occurs most commonly in men over 45.
Risk factors include alcohol, tobacco, caustic injury and atalasia (food fails to pass into stomach)
What are the symptoms of squamous carcinoma?
Dysphagia, weight loss, haemorrhage, sepsis, respiratory aspiration.
Explain oesophageal carcinoma.
Caused by dysplastic change in Barrett’s oesophagus.
More common in males
Can be direct- into surrounding tissues.
Can be lymphatic- to paraoesphageal, parateacheal and cervial nodes.
Can be haematogenous- from liver to lung.
Explain adenocarcinoma
Most common causes of gastric malignancies.
Percursor lessons are pernicious anaemia (atrophic gastritis), intestinal metaplasia, neoplastic polyps, helicobactar gastrisis.
What are the symptoms of adenocarcinoma.
Weight loss
Anorexia
Anaemia
Haemorrhage
Where can adenocarcinomas of the stomach spread to?
Direct infiltration- duodenum, pancreas, colon, liver, spleen.
Lymphatic spread- local and regional nodes, virchow’s node.
Haematogenous- liver to longs.
Transcoelomic
Omentum
Mesentery
Ovary- krukenberg tumour.
What are the risk factors of small bowel neoplasia?
Crowns disease, coeliac, radiation, hereditary GI cancer- e.g familial adenomatous polyposis.
Explain coeliac disease.
Extensive mucosal disease due to the sensitivity of gluten.
Immune mediated villous atrophy and malabsorption.
Can be diagnosed with a serological blood test (TTG) and biopsy.
Symptoms can be reveres within weeks of gluten being removed from diet.
Increase risk of adenocarcinoma and lymphoma in small bowel
What are the symptoms of coeliac?
Pain and discomfort in digestive tract, chronic constipaition and diarrhoea, failure to thrive in children, anaemia and fatigue.
