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ESA 3 - Gastrointestinal System > Gastric Disease > Flashcards

Flashcards in Gastric Disease Deck (101)
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1

Give 3 common gastric disorders

  1. Gastro-oesophageal reflux disease (GORD)
  2. Peptic ulcer disease (PUD)
  3. Helicobacter pylori infection

2

What are the anti-reflux mechanisms to prevent reflux of gastric acid into the lower oesophagus? 

  • Lower oesophagus sphincter 
  • Oesophagus enters stomach in abdominal cavity
  • Pressure in abdominal cavity is higher than that of thoracic
  • Right crus of diaphragm acts as slight around the lower oesophagus 

3

What state is the lower oesophagus sphincter usually in? 

Closed

4

What happens to the lower oesophageal sphincter as part of the physiology of swallowing? 

It transiently relaxes 

5

Why does the lower oesophageal sphincter transiently relax? 

To allow the bolus to move into the stomach 

6

Label this diagram, indicating the main antireflux mechanisms on the right

  • A - Fundus
  • B - Cardia 
  • C - Body 
  • D - Antrum 
  • E - Pylorus 
  • F - Duodenum 

 

  1. Peristalsis
  2. Diaphragm 
  3. Lower oesophageal sphincter 
  4. Intra-abdominal oesophagus
  5. Mucosal valve
  6. Unumpeded gastric emptying

7

Is acid reflex ever normal? 

Yes, some is 

8

How is mild acid reflex normally dealt with? 

  • Secondary peristaltic waves
  • Gravity 
  • Salivary bicarbonate 

9

When do clinical features of GORD occur? 

When antireflux mechanisms fail and there is prolonged contact of gastric juices with the lower oesophageal muscosa

10

What are the clinical features of GORD?

Dyspepsia

11

What is dyspepsia? 

Heartburn

12

What makes dyspepsia from GORD worse? 

  • Lying down 
  • Bending over
  • Drinking hot drinks

13

How is a clinical diagnosis of GORD usually made? 

Without investigation- based on symptoms alone

14

When is there a need to investigate GORD? 

  • When there are alarming symptoms, such as dysphagia 
  • When hiatus hernia is suspected 

15

What investigation is made when a hiatus hernia is suspected? 

Endoscopy 

16

What are the two areas of management for GORD?

  • Lifestyle
  • Medication

17

What lifestyle changes can be made to manage GORD?

  • Loose weight 
  • Stop smoking
  • Reduce alcohol consumption 
  • Reduce consumption of food groups known to aggrevate 

18

What food groups are known to aggrevate GORD?

  • Chocolate 
  • Fatty foods

19

What medications are given to manage GORD?

  • Simple antacids
  • Raft antacids (alginates)
  • PPIs
  • H2 antagonists

20

Give an example of a simple antacid? 

Calcium carbonate 

21

How to simple antacids treat GORD?

They neutralise acid 

22

Give an example of a raft antacid

Gaviscon liquid

23

How to raft antacids treat GORD?

They are taken after eating and create a protective raft that sits on top of the stomach contents to prevent reflux

24

Give an example of a PPI?

Omeprazole

25

How do PPIs treat GORD?

Reduce acid secretion by parietal cells

26

Give an example of a H2 antagonist? 

Ranitidine

27

How do H2 antagonists treat GORD?

They block H2 receptors which reduce acid secretion

28

What are the potential complications of GORD?

Barrett's oesophagus

29

What causes Barrett's oesophagus? 

Continual contact of gastric juices with oesophageal mucus leading to metaplasic change

30

What factors are associated with GORD?

  • Pregnancy 
  • Obesity 
  • Fat, chocolate, coffee, or alcohol ingestion
  • Cigarette smoking
  • Drugs 
  • Systemic sclerosis 
  • After treatment for achalasia 
  • Hiatus hernia