Heartburn

Heartburn

1. Abdullah 55 years old

2. Felt in the chest and the reason is a problem in the GIT system

   • Anatomy of upper GI
     • Esophagus
     • Gastroesophageal junction
     • Stomach
   • Hitology
     • Esophagus
     • Gastroesophageal junction
     • Stomach
       • Fundus/Body
       • Pylorus

3. Swallowing

   • deglutition from placement of food in the mouth through the oral and pharyngeal stages of the swallow until the material enters the esophagus through the cricopharyngeal juncture

4. Gastric Acid Secretion Mechanisms

   • 3 receptors
     • Muscarinic receptors (ACh)
     • Gastrin
     • H2 receptors (Histamine)
   • H+/K+ ATPase or "proton pump"

5. Causes of dysplasia

   • Mutations in a developing fetus' DNA
   • Differential Diganosis
     • Neurological Disorder
       • Cerebrovascular accident
         • Parkinson's Disease
           • Brain stem tumors
             • Degenerative diseases
               • Peripheral neuropathy
     • Motor-end-plate-disorder
       • Myasenthia gravis
     • Muscular disorder
       • Polymyositis
         • Dermatomyositis
           • Muscular dystrophy
             • Cricopharyngeal achalasia
     • Obstructive lesions
       • Tumors
         • Inflammatory masses
           • Trauma/surgical resection
             • Zenker's diverticulum
               • Esophageal web
                 • Extrinsic structural lesions
                   • Anterior mediastinal lesions
                     • Cervical spondylosis
       • Mediastinal masses
         • Lymphadenopathy
           • Substernal thyroid
     • Congenital Anomalies
       • Cerebral palsy
         • Cleft lip palate

6. GERD Gastroesophageal Reflux Disease

   • S&S
     • Chest pain
     • Difficulty swallowing
     • Regurgitation
     • Chronic cough
     • Laryngitis
     • Disrupted sleep
   • Risk factors
     • Obesity
     • Pregnancy
     • Smoking
     • certain medications
   • Diagnosis
     • Upper endoscopy
     • Ambulatory acid (pH) probe test
     • X-ray
     • Esophageal manometry
   • Complications
     • Esophagitis Might develop to:
       • Strictures
         • Barrett's esophagus
   • Lifestyle modifications:
     • Elevation of bed head
     • Weight loss
     • Avoid :
       • Smoking
       • Alcohol
       • Fatty meal
       • Chocolate
       • Spicy food
     • Small frequent meals
     • No eating 3 hrs before sleeping
   • Management
     • H2 receptor antagonist
     • PPI
     • Misoprostol
     • Sucralfate
     • Antacis

7. H.Pylori

   • H. Pylori attacks the lining of the stomach >> acid can get through the lining >>ulcer formation
   • S&S
     • ache or burning pain
     • Nausea
     • Loss of appetite
     • Bloating
     • Frequent burping
   • Risk Factors
     • Living in crowded conditions
     • Living without a reliable supply of clean water
     • Living in a developing country
     • Living with someone who has an H. pylori infection
   • Diagnosis
     • Invasive
       • Histology
       • Upper gastrointestinal endoscopy
     • Non-invasive
       • Urea breath test
       • Stool antigen test
   • Treatment
   • Complications
     • Ulcers
       • Chronic gastritis
         • Gastric Adenocarcinoma

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