Upper GI disorders

Question 1

What are some GI - symptons? (12)

Answer 1

• pain
• Dysphagia - difficulty swallowing
• Odynophagia - Pain on swallowing
• Dyspepsia - discomfort related to upper GI
• Heartburn
• Regurgitation - Unpleasant taste
• Nausea and vomiting
• Diarrhoea - Loose stools
• Constipation - Infrequent (<2/ week) or hard stools
• Steatorrhoea - Pale bulky stools
• Bleeding
• Weight loss

Question 2

What are some non specific oral signs and symptons of GIT disease?

(dental profesionals may be the first to notice a GI disease)

Answer 2

• Angular cheilitis
• Burning mouth syndrome
• Candidal infections
• Recurrent oral ulceration

Question 3

What does angular cheilitis look like?

Answer 3

Question 4

What does Glossitis look like?

Answer 4

Question 5

What does recurrent oral ulceration look like?

Answer 5

Question 6

What is Gastro-oesophageal reflux disease (GORD)?

(upper GI disorder)

Answer 6

Gastro-oesophageal reflux disease (GORD):

Complication resulting from the reflux of gastric contents into the oesophagus or beyond, into the oral cavity or lung.

• Excess acid at lower oesophageal sphincter

• Loss of tone
• Delayed gastric emptying

Question 7

What are the Risk factors for Gastro-oesophageal reflux disease (GORD) ?

Answer 7

Risk factors:

• age
• family history
• obesity
• hiatus hernia

Question 8

What are some symptons of Gastro-oesophageal reflux disease (GORD) ?

Answer 8

Symptoms:

• heart burn
• regurgitation
• relieved by antacids

Question 9

What are some Specific oral symptoms/signs of Gastro-oesophageal reflux disease (GORD)?

Answer 9

Specific oral symptoms/signs:

• reflux dental erosion syndrome
• globus (feeling a lump that doesnt exist in throat)
• unpleasant taste in the mouth
• halitosis
• burning mouth syndrome

Question 10

How do you manage Gastro-oesophagealreflux disease (GORD) ?

Answer 10

• Management:
• lifestyle changes
• PPI
• antacids

Question 11

What surpresses acid?

Answer 11

• Antacids

-Aluminium Hydroxide, calcium carbonate (Rennies) • Alginate-based e.g. Gaviscon

• Gastric acid reduction

• Histamine receptor antagonists (H2 -blockers)
• Ranitidine
• Cimetidine

• Proton pump inhibitors (PPIs)

• Omeprazole
• Lansoprazole

Question 12

What is Peptic Ulcer disease and where is it found?

Answer 12

A break on the mucosal lining of the of the stomach or duodenum

Gastric (stomach) can become malignant

Question 13

What is the epidemiology and Aetiology of Peptic Ulcer Disease?

Answer 13

Epidemiology

• 15-20% of population
• More in elderly
• M=F

Aetiology (study of causes)

• Helicobacter pylori
• NSAIDs (esp. gastric ulcers)

Question 14

What are the symptons of Peptic Ulcer Disease?

Answer 14

Symptoms

• Epigastric pain
• Dyspepsia
• Vomiting
• Anorexia

Question 15

What are the acute and non acute treatments for Peptic Ulcer Disease?

Answer 15

Treatment

Acutely

• Endoscopically – can stop bleeding
• Rarely surgery

Non-acute

• Acid suppression
• PPI (proton pump inhibitors)
• Treat H. Pylori
• PPI and antibiotics (see BNF for regime)

Question 16

What dental aspects do you have to be awear of with upper GI disorders in oesophagus and stomach

Answer 16

• Caution with NSAIDs

• Especially older patients
• In presence of symptoms
• With corticosteroids
• NCTSL (non carious tooth surface loss) with acid reflux
• Halitosis
• Unpleasant taste
• Burning mouth syndrome
• Chronic blood loss
• Failure to absorb Vitamin B12