What receptors are on the basolateral side?
H2 receptor (proton pump to apical membrane)
Ach receptor
Gastrin receptor
What are the other propers of PPIs?
(only 80% acid production blocked from PPI) (also weak anti ATPase, anti urease and antibacterial properties) + antibiotics more effective) - antibiotics concentrate
What are examples of H2 antagonists?
- cimetidine
2. ranitidine
What are examples of PPis?
- Lansoprazole
- Omeprazole
What are examples of antacids?
- Aluminium hydroxide
2. Magnesium carbonate
What was result of OGD report?
sliding hiatus hernia and CLO test negative
When does a hiatus hernia happen?
Part of abdominal viscera herniate through the oesophageal opening in diaphragm
What are the risk factors for a meatus hernia?
- Male gender
- Obesity
- Age
- Pregnancy
- Genetic predisposition
What is the mechanism of a hiatus hernia?
Occur due to a widening of the diaphragmatic hiatus, pulling up of the stomach (e.g. due to oesophageal shortening) or pushing up of the stomach (e.g. due to increased intra-abdominal pressure)
What are the result of a hiatus hernia?
Function of lower oesophageal sphincter comprised and the anti reflux barrier lost allowing stomach contents to reflux into the oesophagus, so common cause of GORD
How common and what is a sliding hiatus hernia?
- 85-95% of cases
- GOJ moves upwards
- Predominately causes symptoms of GORD
How common and what is a rolling hiatus hernia?
- 5-15% of cases
- GOJ remains in place
- Portion of stomach, bowel, pancreas or spleen herniates into chest next to GOJ
Why do you need to monitor GORD?
GORD to barretts (10%) oesophagus small number can form (1-5%) oesophageal cancer
What lifestyle factors would help mr muller?
- Raise one end of bed
- Try to lose weight if overweight
- Find ways to relax
- Not eat within 3 to 4 hours before bed
- not smoke
- not drink too much alcohol
What is the Barrets oesophagus cell changes?
squamous to column
