Upper GI Disease

Question 1

What does GORD stand for?

Answer 1

Gastro-oesophageal reflux disease

Question 2

Features of GORD?

Answer 2

• poor oesophageal clearance

- barrier function/visceral sensitivity

Question 3

symptoms of GORD?

Answer 3

• heartburn
• acid reflux
• waterbrash
• dysphagia
• odynophagia
• weight loss
• chest pain
• hoarseness
• coughing

Question 4

GORD investigations

Answer 4

• endoscopy
• Ba swallow
• oesophageal manometry + pH studies
• nuclear studies

Question 5

is oesophageal carcinoma more common in men or women?

Answer 5

men

Question 6

definition of a carcinoma

Answer 6

a cancer arising in the epithelial tissue

Question 7

definition of adenocarcinoma

Answer 7

Adenocarcinoma is a type of cancer that starts in mucus-producing glandular cells

Question 8

management of GORD

Answer 8

• symptom relief
• healing oesophagitis
• prevent complications

Question 9

lifestyle modifications of GORD

Answer 9

• stop smoking
• lose weight if obese
• prop up the bed head
• avoid provoking factors

Question 10

why would you prescribe antacids?

Answer 10

• symptomatic relief

- no major benefit

Question 11

what H2 Antagonists would you prescribe and what are the pros and cons?

Answer 11

• Cimetidine because rapid symptom relief by less effective at healing
• ranitidine but builds up tolerance and poor at preventing relapse

Question 12

are proton pump inhibitors more effective than H2 antagonists?

Answer 12

yes

Question 13

example of proton pump inhibitor

Answer 13

omeprazole

Question 14

what is Barrett’s Oesophagus

Answer 14

when the cells lining the lower part of your oesophagus (gullet) get damaged by acid and bile repeatedly coming up from your stomach

Question 15

is Barretts Oesophagus reversible?

Answer 15

no

Question 16

what is the management of dysplasia?

Answer 16

• optimise PPI dose
• endoscopic mucosal resection
• radiofrequency abalation
• argon

Question 17

what is gastroparesis?

Answer 17

delayed gastric emptying

Question 18

symptoms of gastroparesis?

Answer 18

• feeling of fullness
• nausea
• vomiting
• weight loss
• upper abdominal pain

Question 19

causes of gastroparesis?

Answer 19

• idiopathic
• diabetes mellitus
• cannabis
• medication
• systemic diseases

Question 20

investigation of gastroparesis

Answer 20

gastric emptying studies

Question 21

management of gastroparesis

Answer 21

• removal of precipitating factors (eg drugs)
• liquids/sloppy diet
• eat little and often
• promotility agents
• gastric pacemaker