Upper GI Disease Flashcards
What does GORD stand for?
Gastro-oesophageal reflux disease
Features of GORD?
- poor oesophageal clearance
- barrier function/visceral sensitivity
symptoms of GORD?
- heartburn
- acid reflux
- waterbrash
- dysphagia
- odynophagia
- weight loss
- chest pain
- hoarseness
- coughing
GORD investigations
- endoscopy
- Ba swallow
- oesophageal manometry + pH studies
- nuclear studies
is oesophageal carcinoma more common in men or women?
men
definition of a carcinoma
a cancer arising in the epithelial tissue
definition of adenocarcinoma
Adenocarcinoma is a type of cancer that starts in mucus-producing glandular cells
management of GORD
- symptom relief
- healing oesophagitis
- prevent complications
lifestyle modifications of GORD
- stop smoking
- lose weight if obese
- prop up the bed head
- avoid provoking factors
why would you prescribe antacids?
- symptomatic relief
- no major benefit
what H2 Antagonists would you prescribe and what are the pros and cons?
- Cimetidine because rapid symptom relief by less effective at healing
- ranitidine but builds up tolerance and poor at preventing relapse
are proton pump inhibitors more effective than H2 antagonists?
yes
example of proton pump inhibitor
omeprazole
what is Barrett’s Oesophagus
when the cells lining the lower part of your oesophagus (gullet) get damaged by acid and bile repeatedly coming up from your stomach
is Barretts Oesophagus reversible?
no
what is the management of dysplasia?
- optimise PPI dose
- endoscopic mucosal resection
- radiofrequency abalation
- argon
what is gastroparesis?
delayed gastric emptying
symptoms of gastroparesis?
- feeling of fullness
- nausea
- vomiting
- weight loss
- upper abdominal pain
causes of gastroparesis?
- idiopathic
- diabetes mellitus
- cannabis
- medication
- systemic diseases
investigation of gastroparesis
gastric emptying studies
management of gastroparesis
- removal of precipitating factors (eg drugs)
- liquids/sloppy diet
- eat little and often
- promotility agents
- gastric pacemaker
