Upper GI Tract Disorders Flashcards
What is included in the foregut?
- distal oesophagus to 2nd part of duodenum
What is included in the midgut?
- 3rd part of duodenum to 2/3 of transverse colon
What is included in the hindgut?
- 3rd part of transverse colon to rectum
What are the main arteries that supply the foregut, midgut and hindgut?
- foregut = coeliac artery
- midgut = superior mesenteric artery
- hindgut = inferior mesenteric artery

What are the 2 main features of swallowing?
- deliver food bolus to stomach
- protect airway from aspiration of food into lung

What is dysphagia?
- general term for swallowing difficulties
Which aspect of the oesophagus is responsible for stopping acid going back up the oesophagus?
- lower oesophagus sphincter

Which cells in the stomach secrete HCl?
- parietal cells

What is the primary protein channel in the membrane of parietal cells that is responsible for creating acid in the stomach?
- H+ / K+ ATPase is the proton pump of the stomach

Is the stomach function generally controlled by the sympathetic or parasympathetic nervous system?
- parasympathetic
What are the 3 ways in which parietal cells secrete HCl?
1 - ACh from vagus nerve (Gaq)
2 - Gastrin (Gaq)
3 - Histamine (Gas) due to gastrin stimulation
What is the direct and indirect action of gastrin on stimulating parietal cells to secrete gastric juice?
- direct = gastrin stimulates parietal cells directly
- indirect = gastrin stimulates histamine release that stimulates parietal cells

Gastrin is able to stimulate parietal cells both directly and indirectly, what type of cell signalling is the direct and indirection action of gastrin on stimulation parietal cells?
- direct = endocrine
- indirect = paracrine (nearby cells)

ACh, gastrin and histamine all work on different receptors on parietal cells, which receptors are present on parietal cells for each of the stimulus?
- ACh = Gaq and ⬆️ Ca2+
- gastrin = Gaq and ⬆️ Ca2+
- histamine = Gas and ⬆️ cAMP and phosphokinase A

What is gastro-oesophageal reflux disease (GORD)?
- leakage of acid from stomach into oesophagus

What are the main cuases of gastro-oesophageal reflux disease (GORD)?
- failure of the lower oesophageal sphincter to close fully
- temporary relaxations of the lower oesophageal sphincter
- failure of the diaphragmatic sphincter
- hiatal hernia
- increased intra-abdominal pressure
How common is gastro-oesophageal reflux disease (GORD)?
- very common
- 20-30% in western world will have regular GORD
- 50% of people will have at least one case of GORD
What is the most common bacterial infection that is a risk factor for Gastro-oesophageal reflux disease (GORD)?
- helicobacter pylori
What are the 3 most common risk factors that can increase intrabdominal pressure and therefore the risk of developing Gastro-oesophageal reflux disease (GORD)?
- obesity
- pregnancy
- ascites
What are some of the most common lifestyle risk factors for developing Gastro-oesophageal reflux disease (GORD)?
- alcohol
- smoking
- physcial activity/exercise
- depression/anxiety
What is the one non-modifiable risk factor for developing Gastro-oesophageal reflux disease (GORD)?
- age
- older people are more at risk
Do all patients with gastro-oesophageal reflux disease (GORD) present with symptoms?
- no
- majority are asymptomatic
Of the patients who do experience gastro-oesophageal reflux disease (GORD) related symptoms, what are the 3 most common symptoms?
1 - acid reflux (”heartburn”) medical term is dyspepsia
2 - burning in chest/throat
3 - reflux of acid into mouth with sour taste
Patients with gastro-oesophageal reflux disease (GORD) may experience the globus sensation, what is this?
- a persistent sensation of a lump in the throat
















