GERD & Gastrointestinal Terms: Week 1 Study Set

What is the term for a failure of the LES to relax?

Achalasia

What are the potential causes of achalasia?

Degeneration of the nerves to the LES

Parasitic infection

Immune disorder (unknown ethology)

Tumour in the esophagus

What parasite can cause achalasia?

Chagas disease

What exam should you perform if you suspect achalasia?

Take vitals

What vital sign could be disturbed in achalasia?

Weight loss

What are the symptoms of achalasia?

Dysphagia

Pressure in chest during or after eating

Nocturnal regurgitation

What age group is most affected by achalasia?

20-40 yo

What are the diagnostic tests for Achalasia

Barium swallow

endoscopy

Esophageal manometry

What imaging modality does barium swallow use?

X-ray

What is the name sign of achalasia on barium swallow imaging?

Bird beak esophagus

Rat Tail esophagus

What is the name of the test where a plastic tube with a light and camera is inserted into the mouth or anus?

Endoscopy

What is the name of the test where a collapsable tube is inserted into the nose, you're made to drink a glass of water, and esophageal pressure is measured?

Esophageal manometry

What are the treatments for achalasia

Chew food thoroughly

Mix solids with liquids

Dilation

Botox

Myotomy

Esophagectomy

What is the term for surgery where the LES is cut open to allow food through?

Myotomy

What is the term of symptomatic reflux from the stomach?

GERD (gastroesophageal reflux disease)

What is the cause of GERD?

Loose LES

What age group is most affected by GERD?

Any age group

What are the main risk factors for GERD?

Pressure in the abdomen

Medications

Angle of the cardio-esophageal junction

Action of the diaphragm

Smoking

Diet (fat, protein, caffeine)

Pregnancy

Hormonal Therapy

Hiatal Hernia

What is the primary way Americans develop pressure in the abdomen?

Obesity

Tight Clothing

Whu medications are primarily associated with GERD?

Calcium channel blockers

Asthma medications

Antihistamines

Antidepressants

What foods can contribute to GERD?

Caffeine

Fatty foods / Protein

Alcohol

What anatomical abnormality can cause GERD?

Angle of the cardio-esophageal junction

What symptoms are associated with GERD?

Heartburn

Pain in the chest or abdomen

Regurgitation

Odynophagia

Water brash

What is the AKA of heart burn?

Pyrosis

What is the term for excessive salivary secretion?

Water brash

What is the term for painful swallowing?

Odynophagia

Which exams should you perform on someone with GERD?

Examine the throat and teeth

What are signs of GERD in the mouth?

Demineralization of teeth

Oral lesions / inflammation of the oral mucosa

What Diagnostic tests are used for GERD?

Upper GI endoscopy

24-hour pH monitor if initial treatment doesn't provide relief

What is an endoscopic finding of GERD?

Inflammation of the lower 1/3 of the esophagus

What are the treatments for GERD?

Lifestyle changes - diet

Antacids

Proton pump inhibitors (omeprazole)

H2 blockers (cimetidine)

Surgery

What H2 blocker is used to treat GERD?

Cimetidine

What proton pump inhibitor is used to treat GERD?

Omeprazole

What is the main side-effect of PPIs?

Kidney damage

What is the term for metaplastic change in the epithelial lining of the lower esophagus?

Barrett's Esophagus

What is the cause of Barrett's esophagus?

Chronic GERD for many years

What % of chronic GERD sufferers develop Barrett's esophagus?

10%

What are the symptoms of Barrett's esophagus?

None (all symptoms are caused by GERD)

What type of change occurs in Barrett's esophagus?

Stratified squamous epithelium to pseudo columnar epithelium (an intestinal-like cell)

What age group is most affected by Barrett's esophagus?

Greater than 50 yo

What test is diagnostic for Barrett's esophagus?

Upper GI endoscopy and biopsy

What test differentiates GERD from Barrett's esophagus?

Biopsy*

What are the treatments for Barrett's esophagus?

Medications to decrease GERD

Endoscopic ablation

Endoscopic mucosal resection

Surgery

Which types of tumors can occur in the esophagus?

Squamous cell carcinoma

Adenocarcinoma

What is the term for a cancer of glandular origin?

Adenocarcinoma

What type of cancer is Barrett's esophagus a risk factor for?

Adenocarcinoma

What are the risk factors for esophageal cancer?

Smoking

Alcohol

HPV

Plummer vinson syndrome

Achalasia

What type of esophageal cancer will not have symptoms until later in the process?

Squamous cell

What are the later symptoms of esophageal cancer?

Difficulty swallowing

Referral of back pain

Unexplained weight loss

Vocal cord paralysis / hoarseness

What are the diagnostic tests for esophageal cancer?

Upper GI endoscopic test with biopsy

Chest CT

Barium swallow

What are the treatment options for stage 1/2 esophageal cancer?

Surgery

Radiation

Chemotherapy

Laser therapy

What is the term for inflammation of the lining of the GI tract?

Gastroenteritis

What is the most common viral cause of gastroenteritis in young children?

Rotavirus

What part of the intestines do viruses infect?

Villous epithelium of the small intestine

How long does rotavirus gastroenteritis last?

3-7 days

What is the most common viral cause of gastroenteritis in adults?

Norovirus

What type of virus is norovirus?

A calicivirus

How long does norovirus gastroenteritis last?

1-3 days

What species of bacteria commonly cause gastroenteritis?

campylobacter jejuni

e. Coli

salmonella

shigella

staphylococcus

What is the method by which bacteria can cause gastroenteritis?

Exotoxigenic material

Endotoxigenic material

Enteroinvasive infection

T or F: Parasitic protozoans are a potential cause of gastroenteritis?

True

What are some gastroenteritis causing parasites?

Giardia

Cryptosporidium

What other types of viruses can cause gastroenteritis?

Astroviruses

Adenoviruses

What is the distinguishing symptom of bacterial gastroenteritis?

Bloody diarrhea

What defines a low-grade fever?

less than 101 F

What is the upper limit of normal body temperature?

99.1

What are the symptoms of viral gastroenteritis?

Watery diarrhea

Abdominal cramps and pain

nausea/vomiting

Muscle aches or headache

Low-grade fever

What is the primary exam findings of gastroenteritis?

Dehydration

What is the diagnostic test for gastroenteritis?

Stool culture-identify pathogen

What tests are done if infection is present in gastroenteritis?

CBC

Lower GI endoscopy

What are the treatments for gastroenteritis?

Do not eat solid foods for a few hours

Suck on ice chips or small sips of water

Avoid dairy, caffeine, alcohol, nicotine, fatty or spicy foods

Rest due to dehydration