00:00 / 00:00
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Benign liver tumors
Cholestatic liver disease
Non-alcoholic fatty liver disease
Primary biliary cirrhosis
Primary sclerosing cholangitis
Pancreatic neuroendocrine neoplasms
Familial adenomatous polyposis
Juvenile polyposis syndrome
Small bowel ischemia and infarction
Protein losing enteropathy
Short bowel syndrome (NORD)
Small bowel bacterial overgrowth syndrome
Diverticulosis and diverticulitis
Irritable bowel syndrome
Cleft lip and palate
Congenital diaphragmatic hernia
Diffuse esophageal spasm
Eosinophilic esophagitis (NORD)
Gastroesophageal reflux disease (GERD)
Cyclic vomiting syndrome
Gastric dumping syndrome
Dental caries disease
Gingivitis and periodontitis
Temporomandibular joint dysfunction
Appendicitis: Pathology review
Cirrhosis: Pathology review
Colorectal polyps and cancer: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diverticular disease: Pathology review
Esophageal disorders: Pathology review
Gallbladder disorders: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Malabsorption syndromes: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Viral hepatitis: Pathology review
0 / 7 complete
0 / 3 complete
Gastroesophageal Reflux Disease (GERD) Assessment
Structural Esophageal Disorders & GERD
esophageal pathology and p. 384
H2 blockers for p. 405
proton pump inhibitors for p. 406
gastroesophageal reflux disease p. 384
esophageal cancer and p. 385
presentation p. 384
Gastro- refers to the stomach, esophageal stands for esophagus, and reflux means “to flow back”.
So gastroesophageal reflux disease, or GERD, is when stomach acid flows back into the esophagus.
The presence of acid in the esophagus can lead to Barrett’s esophagus, a serious complication of GERD where the normal mucosa of the esophagus is replaced by one that’s similar to that of the intestines.
Barrett’s esophagus poses a higher risk of developing esophageal adenocarcinoma.
Normally, the wall of the entire gastrointestinal tract is made of 4 layers: the inner mucosa, the submucosa, a muscular layer, and an outer layer called the adventitia.
The mucosa is further divided into three layers - an innermost epithelial layer, a middle layer called the lamina propria, and an outermost layer, in contact with the submucosa, called the muscularis mucosae, which is made up of smooth muscle that contracts and helps with the breakdown of food.
Now, the stomach mucosa is different from the esophageal mucosa.
Inside the stomach, the epithelial layer is made up of cylindrical cells, which dive into the lamina propria, forming pits.
These pits are the gastric glands, and there are many of them scattered throughout the stomach.
Distributed among the cylindrical gland cells, there’s different types of secretory cells.
First, there’s G cells, which are a type of neuroendocrine cells that secrete a hormone called gastrin in response to food entering the stomach.
Gastrin stimulates another type of cells, the parietal cells, to release hydrochloric acid.
And then, there’s chief cells, which secrete an enzyme called pepsinogen.
Hydrochloric acid and pepsinogen are useful for digestion, but they can be quite aggressive for the delicate mucosa.
Luckily though, the stomach also has some defense mechanism in place.
First, the gastric glands also have foveolar cells, also called surface mucus cells, because they are closer to the surface of the stomach, and they secrete mucus.
Mucus is mostly made up of water and glycoproteins, and also bicarbonate ions which are also secreted by foveolar cells.
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