Gastroesophageal Reflux and Ulceration Quiz

Gastroesophageal Reflux Disease (GERD)

• Associated with incompetent barriers at the gastroesophageal junction
• Caused by decreased lower esophageal sphincter tone or hiatus hernia
• Reflux esophagitis ranges from mild to erosive
• Occurs when mucosal defenses are insufficient to protect the esophagus from acid, pepsin, and bile
• Symptoms include heartburn or atypical chest pain
• Excessive gastric distension, fatty meals, smoking, and beverages (high xanthine content) relax the lower esophageal sphincter, facilitating gastric reflux

Ulceration

• Ulcer is a disruption of mucosal integrity, leading to excavation due to inflammation
• Stress, ingested substances (aspirin, NSAIDs, ethanol), hyperosmolar meals, and microorganisms (e.g., H. pylori) can disrupt the epithelial layer, causing ulcers
• Initial ulcers may heal, or be further aggravated by local agents
• Ulcers can potentially lead to additional gastric and duodenal ulcers

Atrophic Gastritis and Pernicious Anemia

• Atrophic gastritis involves reduced numbers of parietal and chief cells
• Loss of parietal cells decreases intrinsic factor production needed for vitamin B12 absorption
• Pernicious anemia is a consequence of vitamin B12 deficiency due to a lack of intrinsic factor
• Vitamin B12 absorption usually occurs via pinocytosis in the ileum
• In some cases, pernicious anemia is linked to autoimmune responses against parietal cell proteins
• Oxyntic cells are the site of intrinsic factor production which is needed for vitamin B12 absorption

Autoimmune Atrophic Gastritis (AAG)

• AAG affects oxyntic mucosa

Carcinoid Tumors

• Arise from enteroendocrine cells
• Cause symptoms due to excessive serotonin production
• High serotonin levels can lead to mucosal vasoconstriction and damage
• Serotonin increases gut motility

Malabsorption Syndrome

• Deficiencies in disaccharidases enzymes cause digestive disturbances
• Some enzymatic deficiencies are genetic
• Nutrient absorption is hindered by intestinal mucosal atrophy (due to infections or nutritional deficiencies)
• This leads to malabsorption syndrome

Appendicitis

• Appendix's closed-ended structure makes it prone to inflammation (appendicitis)
• Frequent causes include luminal obstruction (fecalith, enlarged lymphoid follicles, viral infection, tumors, worms) and mucosal ulceration

Adenocarcinomas

• 90-95% of malignant digestive system tumors originate from intestinal or gastric epithelial cells
• Almost exclusively originate from glandular epithelium in the large bowel (adenocarcinomas)
• Carcinoembryonic antigen (CEA) is an important diagnostic marker for cancer, produced exclusively by malignant cells.

Hemorrhoids

• Enlargement of submucosal venous plexuses in the anal canal leads to hemorrhoids
• Common in pregnancy and individuals over 50
• Symptoms include painful defecation, fresh blood with defecation, and anal itching

Test your knowledge on Gastroesophageal Reflux Disease (GERD) and ulceration. This quiz covers key concepts such as causes, symptoms, and factors affecting mucosal integrity. Understand the connections between stress and various substances on GI health.